I am going to post an image of a sample curve - part of the curve is a miscellaneous choice of readings but the first ones are Sissy's readings posted yesterday for the morning.
In this curve, the insulin has good duration, which is defined as the blood sugar returning to a level no higher than it started out. So if the blood sugar starts at 381 as Sissy's did yesterday, the NPH has a good 12 hours of duration as long as the blood sugar is basically the same or less at dinner time. In this case, hers was 306, so she might actually have had some insulin action from her breakfast injection still working at dinner time.
It's somewhat counterintuitive... it's not that the blood sugar should never go up during 12 hours, it's a matter of how much it goes up and relative to where it started.
So if there's an off day and blood sugar starts at 600, you can't expect the same dose of insulin to bring that blood sugar to the usual 300 by dinner time.
In this curve, the insulin has good duration, which is defined as the blood sugar returning to a level no higher than it started out. So if the blood sugar starts at 381 as Sissy's did yesterday, the NPH has a good 12 hours of duration as long as the blood sugar is basically the same or less at dinner time. In this case, hers was 306, so she might actually have had some insulin action from her breakfast injection still working at dinner time.
It's somewhat counterintuitive... it's not that the blood sugar should never go up during 12 hours, it's a matter of how much it goes up and relative to where it started.
So if there's an off day and blood sugar starts at 600, you can't expect the same dose of insulin to bring that blood sugar to the usual 300 by dinner time.
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