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Re: [IPk] Late blood sugar rises

Hi Jackie, 

Is it possible to check the basal rates (i.e. to give her dinner 6 hrs
after mid=afternoon snack?)  If there is a drop mid-evening, then you
simply need to under-dose the Novorapid for dinner.  If you then get a
rise later in the evening, as the Lantus is wearing out, then another
small shot of Novorapid might do the trick. 

If it's a case of her dinner profile being a longer one than the
novorapid, injecting afterwards might work.  Or swithcing to actrapid
for her evening meal, as it has a wee bit longer profile.

Best wishes,


 In message <email @ redacted>,
Jackie Jacombs <email @ redacted> writes
>Hi all
 > I am wondering if anyone has any advice. Sasha has now been on Lantus for
>two weeks. Things
> aren't going too badly and Sasha's blood sugars are more predictable. We have
>had to reduce the starting
> dose of Lantus which was 14 units ( Sasha previously took 17 units of NPH +
>Novorapid with meals) Sasha
> now takes 11 units of Lantus which we give in the morning, as in the past we
>have always had problems
 > with overnight hypos. We seem to have to level of Lantus set correctly, in
>two hours after
> breakfast Sasha's blood sugars are still within the target range and hours
>later they haven't changed
 > that much. They have been dropping very slightly after 10.30 am so Sasha has
>apple or biscuit which
 > would have been her normal snack time. By the time 12.00 midday comes her BG
>usually still within the
> target range 4.5 - 7.00. However the problem we are having is that, if I give
>her the same insulin to
> carb dose for 65 carbs for the evening meal (or usually slightly less, as she
>has a higher insulin to
 > carb rate at breakfast) Sasha seems to go low and sometime below 3.5.
>the levels are OK , but
> later on, after about 9.30 pm her blood sugar levels seem to rise and then
>carry on rising until we
 > correct. Last night Sasha was 9.7 mmols at 10.30 but then her BG rose again
>at 2.00am it was
 > 11.5 mmols. I don't know if this is due to the sort of meal that she is
>Tuesday was a large GF
> chicken burger, Wednesday was curry and rice. Both of those meals had more
>protein in than Sasha usually
 > eats as she doesn't really like eggs or meat. If we correct the levels early
>the night then the
> levels will stay about the same level throughout the rest of the night. So
>although two hours after the
> evening meal her BG is low, or in range then it continues to rise to about
>16-17 mmols sometimes but this
> is usually 5 hours after the meal. I don't think we can increase the Lantus
>more as she already drops
> slightly in the morning. If it is protein or fat causing the rise how do you
>dose for this. I cant
 > really give any more Novorapid with the meal. Does one just have to wait
>the rise had happened or
> The only other thing I can think of is switching the Lantus to the evening to
>see if this helps. Which
>we didn't really want to do.
>Any ideas of what might be happening.?
>Mum of Sasha aged 9 dx 1999
>email @ redacted
>for HELP or to subscribe/unsubscribe, contact:

Pat Reynolds
email @ redacted
   "It might look a bit messy now, 
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