Comments on Death of a Pancreas: Why I don't hate NPH

i am so glad NPH worked so well for you! as bennet...

2012-01-12T12:28:12.809-08:00

i am so glad NPH worked so well for you! as bennet says, your diabetes may vary.

i, on the other hand, HATE NPH. the very letters strike fear in my heart. but that's because NPH was the cause of three low seizures for me as a kid. scary stuff.

i love this post because it really does illustrate YDMV, and the importance of not judging others for choosing to treat their diabetes differently than you.

I have a 5 year old boy (diagnosed at 3) that is o...

2012-01-10T17:16:29.736-08:00

I have a 5 year old boy (diagnosed at 3) that is on Humalog and NPH, and he's only on morning and bedtime insulin. That's 2 shots per day people! As long as he gets activity in the late morning or early afternoon, we don't need supper insulin. He loves the NPH with his whole heart and soul. Me a little less, because I am the clock watcher/food lugger/night tester, but it works for now. I imagine this magic will wear off when he grows a bit bigger.

I've enjoyed so much reading your blog for the...

2012-01-09T19:25:04.802-08:00

I've enjoyed so much reading your blog for the past week. I really wish these blogs had been around when my son was diagnosed in 1997 at age 4.

At that time we used NPH and R (Regular) because that was all that was available to us. When Humalog came along, well, as you would say, I wanted to roll around naked in it, run off to Vegas and get married to it, I was so in love with it. He got one shot of NPH and R and one shot of H in the morning (could not mix H with NPH and R), and I think we ended up doing H at dinner and NPH at bedtime after much experimentation.

But, even after we started using Lantus and got rid of the R, we continued using NPH with H in the mornings until he was in high school. It was unusual, but it worked for us and he didn't need shots at lunch, which really worked for us.

Caring for a child with diabetes is a marathon, not a sprint--when you have a groove and it's working for you, you stick with it. I cannot imagine caring for a baby with diabetes--4 was young enough, but not even on the same planet as having a baby. You're doing a fabulous job!

Kat

Great post . . . I'm such a hater! :)

2012-01-09T18:30:22.206-08:00

Great post . . . I'm such a hater! :)

We only used NPH for the first month of diagnosis ...

2012-01-09T17:09:33.667-08:00

We only used NPH for the first month of diagnosis with very poor results. Her BGs stayed in the 250 to 300 plus range, they had to increase her TDD to 18 units a day and she was 50 pounds. Humalog dose is included in the TDD. On Lantus and Novolog she had great blood sugars within a week and she needed less basal, 7 units a day. If someone says they love NPH then I just assume it obviously works for them. Everybody is different. What works well for one may not work well for another. But I did assume since the nickname for NPH is "not particularly helpful" that most perceive NPH as an unpredictable insulin. Each Mom knows her own child and if NPH works well for Elise that's great. You do only need two shots a day with it, and it is an inexpensive insulin.

Wow! Joanne, this post was amazing and informative...

2012-01-09T15:36:37.905-08:00

Wow! Joanne, this post was amazing and informative. As someone who has never used it, but has heard of it...what a great way to get an understanding of how it works. I had no idea Elise only got 3 shots a day and could graze! Amazing. Totally "get" why you loved it. And I always wondered what "magic" you used to get those beautiful straight-ish CGM lines. :)

I have to agree with you - NPH can be great. We u...

2012-01-09T11:24:45.618-08:00

I have to agree with you - NPH can be great. We used nph from diagnosis in 2nd grade through 4th grade. It worked great, peaked around her school lunch time, didn't require an injection at school, etc. In 5th grade everything changed with a later lunch time. Instead of trying to move the morning nph we went to levemir and novolog shots at every meal. Ava was older and could do the pen injections herself. Both ways were fine. Now we're pumping on omnipod and loving it (although this weekend was crazy - a ski accident requiring pod removal for x-rays and defective spare pod! Oy!)

Bottom line, there isn't any one right way to manage this crappy disease.

NPH is my friend and my foe! I am a clock watcher ...

2012-01-09T10:08:03.244-08:00

NPH is my friend and my foe! I am a clock watcher for sure...lately it has been peaking when I least expect it to. So glad that you guys were able to get it to behave itself for you.

YOU, my friend, are a NPH ROCKSTAR! I probably w...

2012-01-09T09:23:21.405-08:00

YOU, my friend, are a NPH ROCKSTAR!

I probably wouldn't have such a poor opinion of NPH if the endo would have considered diluting her dose.

But this is the same endo who put her on a Novolog breakfast ratio of 1:10 (at 25 lbs) when we switched to Lantus...because they were "streamlining" the care for ALL diabetic patients on insulin -- didn't matter the age, other medical history, or type of diabetes. If you were on insulin in this practice, you got a breakfast ratio of 1:10. PERIOD.

I spent the better part of that 7 months feeding insulin, watching the clock, chasing lows, and living in a constant state of panic... just waiting for the next time she would pass out.

I was a scared mother, and called the office over and over again, begging for help.

They told me it was normal. It's just the way it was going to be, because her life depended on insulin.

Maybe NPH/MDI would have been easier had we been able to access a CGM -- they were practically unheard of when Addy was dx.

Maybe a lot of things.

I don't know.

I just know that I'm incredibly grateful for ZERO basal rates, micro insulin doses, and IOB.

Not to mention the superfab endo who intervened...who, btw, I will follow to the ends of the earth.

I am actually old school - I love NPH and still us...

2012-01-09T06:00:28.881-08:00

I am actually old school - I love NPH and still use it whenever I have to go off my pump. I'm experienced with NPH and know exactly how it works in my body. Also, as someone who is fairly active, NPH's "intermediate" status means that I can more easily adjust for intensive physical activity. Finally, the newer basal insulins scare me - they were approved very quickly and have not been used for all that long. NPH has been in use almost as long as insulin has existed and this means we are well-aware of its long-term side effects (none). As I always say, when dealing with type 1 diabetes, you've gotta find what works and just stick with it.

I think this is a great piece for people who may n...

2012-01-09T05:47:58.358-08:00

I think this is a great piece for people who may need some guidance with NPH -- and also, a great definition of what NPH is, because I never really understood what it was.