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Question:

From Klamath Falls, Oregon, USA:

I have had type 1 diabetes for 17 years and just got on new insulin (Ultralente instead of NPH). I tried supper Ultralente and bedtime Ultralente. My blood sugar at 3:00 am is low and I have to eat. At 5:30 am, it is low again, and I have to eat. By breakfast it is usually around 70 mg/dl [3.9 mmol/L]. I went from 10 Ultralente to 5 Ultralente and have the same test results. I can't sleep because of being scared of not waking up. I have been as low as 23 mg/dl [1.3 mmol/L] at 3:00 am. Do you think I could just take the Ultralente in the am and no Ultralente at bed? I cover all food with Humalog except my bedtime snack.

Answer:

It sounds as though you were placed on Ultralente insulin, and I'm not sure you ever had satisfactory control. However, Ultralente is tricky to use for several reasons. It has a longer duration of action than does NPH. That means when the dose is changed, you may experience a delay in any observed change in your blood sugars. In addition, I tend to use two shots a day because one shot infrequently is adequate for all basal needs. Finally, there is a point during the crossover from NPH to Ultralente where there is NPH on board with Ultralente which can cause the blood sugars to fall. I would try and get some help with your physician on this.

JTL

DTQ-20001016162422
Original posting 16 Nov 2000
Posted to Hypoglycemia

  
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Last Updated: Tuesday April 06, 2010 15:09:16
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