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From Minnesota, USA:

We recently moved my son, age six, diagnosed one year ago, 5'4", 54 pounds, to a new insulin regimen, as follows:

A.M. -- 4 units H and 7 units NPH
P.M. -- 2 units H and 2 units R
10:30 P.M. -- 2 units NPH

My son never sleeps through the night. He wakes up, gets a drink, goes potty and back to bed and has glucose readings in the 200-250 range each morning. Any ideas?


I would recommend first trying your new routine for several days and see what the new pattern of blood sugar control is. If he is still waking up high, you might want to try testing his blood sugar every 3 to 4 hours during the night for a few nights to see when during the night the blood sugar is high and when it isn't. One always has to be careful not to push the blood sugar too low during the night while the child is sleeping when trying to lower the fasting blood sugar. When you see the pattern of the blood sugars, you and your child's doctors can try to figure out which insulin to change to try and lower the fasting blood sugar without causing lows during sleep. You may need to change either the amount of insulin he is already taking, change the time of the dose, or consider a different nighttime insulin such as Ultralente, depending on the nighttime pattern of blood sugar you get.


Original posting 11 Oct 97


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