Replies to This Discussion

Permalink Reply by acidrock23 on December 11, 2012 at 5:09pm

When I got my pump, I was going from NPH to the pump. The doc and Medtronic SalesNurse mentioned and agreed that NPH has a 53% chance of peaking when it's supposed to. In retrospect, this may have explained a lot of the "woah, I was high at lunch and then crashed out in the afternoon..." results I'd seen for years but, since I was really lazy and didn't log anything, I don't have any real evidence or documentation about it.

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Permalink Reply by Sweet Fur on December 11, 2012 at 5:10pm

So what time did you inject, and what time did you see it peaking?

Thanks!

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Permalink Reply by acidrock23 on December 11, 2012 at 5:51pm

First thing in the AM and last thing at night most of the time. It seemed to work better when the PM shot was later. I did a lot of correction boluses and much wilder rollercoastering than I do these days but I also wasn't organized at all about it. Sorry I can't provide better information!

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Permalink Reply by gene on December 11, 2012 at 5:53pm

For me I would say the peak starts on hour 5... mostly. Hours 5-8 I change my carb ratio , then it tapers off.

On a side note I only use my stomach for basal injections as it just seems slightly more consistent.

Unfortunately I can't say it'sair tight. Often adding or subtracting an hour from either end.

"woah ..." -acidrock23

Hope that helps.

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Permalink Reply by Trudy on December 11, 2012 at 6:11pm

Hi Sweet Fur (love your avatar!) You need 24 hours coverage of basal; NPH needs to be taken twice daily to cover the 24 hours. You need to time those shots (roughly morning and night) so that you can take care of the peaks -- the nightly shot's peak around the time you will experience the dawn phenonomen, the morning shot at a time that you can eat something when it peaks. The peaks aren't always consistent in their timing with NPH, as AR said. I also had highs and (sometimes very low) lows with NPH, but I now have consistent results with Levemir (which also must be taken twice). You can certainly use NPH, but you must be careful.

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Permalink Reply by KML on December 11, 2012 at 7:14pm

I have just recently been taking off of NPH (1.5 weeks) and am pumping for the first time. I took NPH at 9 p.m. and 9 a.m. I never had much trouble with lows in the morning because of of Dawn and her stupid Phenomena... but I would without fail be STARVING and often low between the hours of 3-5 p.m. If I exercised, (which i do often) I had to eat a load of food. I was put on NPH when I was pregnant and although the baby did not stick I remained on NPH to try and conceive otherwise; I do not think I would have made the sacrifice. My control was decent, well my A1c was good.. but it was nerve wracking at times. TEST OFTEN! Can I ask what this experiment is for and why?

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Permalink Reply by MegaMinxX on December 11, 2012 at 7:15pm

In 1985-90s, I used NPH + R at breakfast, and the NPH would peak about 5 hours later to cover lunch. (No R at lunch). At dinner, I used R only, then a smaller dose of NPH at bedtime. The bedtime NPH peaked early am to help cover DP. I usually ate a small snack w/protein at bedtime to prevent from going low overnight.

I think my total NPH was about 25U, and took 2/3 in the am, and 1/3 before bed.

I've heard that some split the NPH into 3 or 4 smaller doses/day, to avoid the lunch time peak, and use R or Humalog/Novolog for each meal.

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Permalink Reply by Holger Schmeken on December 12, 2012 at 12:24am

What type of experiment? NPH is lasting for 24 hours but most of its activity is gone after the 12 hour mark. Thus you will need two shots per day to have a more evenly distributed activity. One shot pr day will be a disaster if you are fully insulin dependend. The peak is around 5 to 6 hours after injection. To treat dawn phenomen the peak is too early and too strong.

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