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From North Carolina, USA:

Can one develop resistance to long acting insulin (NPH)? My morning blood sugars are high. During the day when I take Humalog, they are more stable. Increasing the night time shot does not seem to help.


Not at all. I think what you observe (called the dawn phenomenon) is quite common due to relatively low doses of insulin over the first part of the nighttime secondary to the short half-life of the supper dose of lispro insulin [HumalogŪ brand].

It sounds as you should first check whether:

  1. The NPH is injected at a sufficient dose and at bedtime;

  2. The 3:00 A.M. blood sugar is okay, to be sure that you avoid the Somogyi Effect

and then adjust your regimen accordingly, under the supervision of your diabetes team.


Original posting 9 Jun 1999
Posted to Hyperglycemia and DKA


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