I'm not sure of what insulin your daughter is on (Lispro/N) but there are new, better insulins; lantus - levemir for basal, aprida, novolog, humalog for fasting acting basals, also the insulin pump, which many young, young children use.
Lispro is marketed under the name Humalog.
These problems are pretty well-known with the older insulins. You say you can't switch to MDI. What about having someone to bolus for her at lunch? You will, unfortunately continue to have these problems; that's why most people are on the newer insulins.
The Humalog (Lispro) is no longer active at lunch time, the small 1u dose is only going to last about 4 hours so she
has no active insulin to cover lunch. The NPH is her basal insulin and if you increase the dose she will go low especially
on days when her activity level is increased and the NPH will not cover her lunch.
Oh, I didn't realize "lispro" was Humalog, a bolus insulin. If you are using bolus for mealtimes, you need to use it for all meals. And you need to figure out I:C ratios, so that you are dosing for the food she eats, not just taking a set dose no matter what she eats. I really don't understand how you are combining NPH and Humalog. You are using her NPH (basal) to cover her lunch? That's going to work poorly at best. I feel like I'm sounding negative, but if you use more up to date tools in a correct MDI regimen (one or two doses of long-acting basal and an injection of Humalog before each meal based on the I:C ratio you determine) it will be sooo much easier! What you'll lose in logistics (having to either find someone to bolus for her lunch or get there yourself) you'll gain in stability of her blood sugars, which I know will reduce anxiety!
I apologize, Jen, I was completely in the dark about the hybrid system for children and just assumed it was outdated insulins which are, unfortunately all too common. I learned something! Not that that helps you any! Have you tried posting to the parents groups so other parents using the same regimen can share their input? I'm a big believer in learning from peers when it comes to D!
you're on MDI's, multiple daily injections, no? i've never heard of this type of treatment for peds?