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From Misawa, Japan:

I am a 44 year old, type 1 diabetes at age 40. My glucose has been well controlled until about six weeks ago. I use Humalog (at each meal) and NPH (twice a day). Since then, I wake with 220 mg/dl [12.2 mmol/L] and seem to stay high all day. I also have lost about 20 pounds during this period. Back in the states I would go to a doctor, but my resources are limited while I live here in Japan. Can you help me out?


I'd advise my patients to try to adapt their lispro doses to the new environment with some extra lispro between meals. Longer waiting times, after insulin and before eating, is worthwhile too. NPH should assure relatively good fasting values. If this is not the case, increase NPH at bedtime.


Original posting 1 Oct 2000
Posted to Daily Care


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Last Updated: Tuesday April 06, 2010 15:09:14
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