From San Angelo, Texas, USA:
I am a forty year old white male with insulin dependent diabetes for 22 years. My insulin regimen is 10 units Humalog - breakfast, 7 units Regular - lunch, 10 units Regular - dinner, and 10 units Lente at bedtime. All dosages are on a sliding scale based on blood sugar test results. My glycohemoglobins usually run from 6 to 8.5. My problem is that my fasting blood sugars usually run from 170 to 220. My blood sugar at bedtime is usually 120 to 140. Any attempts to increase the bedtime dose of Lente results in an insulin reaction around 2 A.M. Obviously starting the morning with a large dose of Humalog to rapidly decrease the dawn effect is an overcorrection that would not be necessary if the fasting blood sugars were not so high.
Do you have any suggestions on changes in regimen that could reduce the morning effect? I have taken data points in the middle of the night and I don't think I'm having the classic reaction rebound in the middle of the night. The data shows my blood sugar begin to increase about 4 A.M. Reduction of the nighttime Lente makes the fasting blood sugars even higher.
I would discuss with your doctor possibly substituting part or all of your evening Lente with Ultralente which lasts longer.
Original posting 8 Mar 1998
Posted to Hyperglycemia and DKA
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