happy valentines day peeps! a question for all of you on mdi-im on mdi and there is no chance in hell of getting a pump or cgm. none. is it a realistic goal to want to have morning fasting numbers below 100 on a regular basis?

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That's a good goal. I never really managed to hit it very regularly on MDI. Oddly, the only times I seemed to reliably have normal/ good BG in the AM were when I drank *a lot* the night before. I only used NPH though so I can't really speculate on Lantus/ Levemir.

Oddly? The liver has invested itself in saving your life. Thus it will restore and rebuild itself after a some hours. After drinking at night this usually happens in the morning hours and this will supress the dawn phenomenon.

i know! i have a couple of glasses of wine and i wake up in the 80s! thats even eating a snack before bed! i joke ill have to become an alcoholic to get good am numbers, but maybe theres something to it...

This is a topic I'm interested in delving into to some extent. I don't want to use diabetes as a reason to drink more than I should, but having one too many sure as hell does seem to help with the glucose levels the following day, doesn't it?

god, yeah! lets me pig out with my hangover hunger!

Have you tested your BG from 3 to 4 am? With a target of 80 you might have overslept many lows. When do you inject your NPH?

I want Sally's Diabetes!

Nope, then you'd be stuck with mine! Even with a pump, with working my butt off, I couldn't possible stay between 80-100. Oh well, could be worse!

You must be still honeymooning, Sally. Your residual beta cells are still acting as a buffer. If the NPH is overly active your beta cells will compensate that by reducing their output. Thus you do not see the profile of the NPH activity in your numbers yet. Hopefully you are LADA for life (high level of residual beta cells).

My understanding, Holger, is that there is no reason to believe that LADA's have a high level of residual beta cells for life, but simply that it takes longer for them to get destroyed. LADA just refers to the slower onset (destruction of beta cells) which occurs over a few months or a few years rather than all at once.

Bernstein definitely helps all around. I'm sure I'd have a lot better profile if I did it, but would find it hard to stay vegetarian which is important to me. Life is all about choices.

I didn't realize it's been five years for you, Sally (though that's still within the range of LADA). Have you had a c-peptide recently?

I just wanted to say thank you for this brilliant idea for NPH injection schedule.

Let me ask you - do you find you need significantly less insulin around 2-6 pm? As in, if you were to exercise or do something different, do you tend to go low then?

I would go off my pump if I could figure out a way to cover all the times around 2-6 and not go low during that time frame. I've been experimenting with NPH because (in theory) I'm hoping it will be mostly out of my system around that time.

Thank you!! And I'm open to any ideas you may have if you are in a similar situation.

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