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Question:

From Laconia, New Hampshire, USA:

I am now 26 and have had type 1 since I was eight. I try hard to keep my diabetes under control. My HbA1c levels are under 7% but I can't seem to get my fasting sugars down. They are inconsistent, sometimes high, sometimes normal (80-120 mg/dl [4.4-6.7 mmol/L], and are currently around 200-275 mg/dl [11.1-15.3 mmol/L]. I am taking Ultralente at night and in the morning (15 at night, 18 in the am). I have tried increasing my morning dosage, but doesn't seem to affect my sugars. Can you please help?

Answer:

The problem of persistent hyperglycemia before breakfast on Ultralente insulin is not an unusual problem. In roughly a third of patients on Ultralente, there is a need to give some additional insulin which peaks in the am, corresponding to the increased insulin resistance which comes with the early morning. There are several options. These include adding a dose of NPH at night before bed or switching away from Ultralente entirely. In short, there are solutions to your problem. I would recommend speaking with your physician caring for your diabetes for the best choice.

JTL

Additional comments from Stephanie Schwartz, diabetes nurse specialist:

You might also explore the possibility of an insulin pump. You can explore a lot about it by looking at Is pumping for you?.

SS

DTQ-20000918094706
Original posting 12 Oct 2000
Posted to Daily Care

  
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Last Updated: Tuesday April 06, 2010 15:09:14
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