Ask Our Team
My son awakes on a daily basis at over 300. He seems to be rising steadily after about 3am. Is there anything you can suggest that may help? He is on Novorapid at mealtimes and levimir at breakfast and lunch and lantus at night. If ever I raise the dosage of levemir he hypos at about 2am.
Responses
Gary Scheiner says
If you are fairly certain that he is rising after 3am (this can easily be verified by using a continuous glucose monitor for a few days; it could also confirm that he is not dropping low soon before the rise), there are potential solutions. The obvious one would be to switch to an insulin pump. The rate of basal insulin delivery on the pump can be increased starting at around 1-2 am to offset the rise that takes place after 3am. Another option would be to add a small dose of NPH insulin at bedtime (10-11pm). The NPH peak could effectively offset the middle-of-the-night rise. We have used this strategy with several of our clients and it has worked quite well.The whole issue of taking 3 injections of long-acting insulin (1 glargine/lantus, 2 levemir/detemir) is another story. I have never seen a need for taking two different long-acting insulin types and cannot fathom why you might be using this approach.
Anyway, let me know if you would like to discuss this further. My e-mail is gary@integrateddiabetes.com or visit my website Integrated Diabetes Services.
