A report published in the August 1992 issue of Diabetes Care predicts that the early morning high blood sugars (hyperglycemia) experienced by Type I diabetes patients could possibly be the result of their current insulin therapy. With a twice-daily dosage of combined human lente and regular insulin (HL/R) injections, blood sugar levels may rise from a lack of insulin early in the morning, when it is needed most.

Researchers from the Department of Pediatrics and Medicine at the Indiana University Medical Center, Indianapolis, compared the effects of human ultralente insulin (HUL) and human lente insulin on morning fasting blood glucose levels. The purpose of the study was to determine whether a twice-daily regimen of human ultralente insulin combined with regular insulin (HUL/R) would improve raised morning blood sugar levels and metabolic control in children with Type I diabetes.

The researchers developed a twice-daily injection regimen using HUL insulin in their study. The authors of the report note that since HUL insulin has a longer duration and a diminished peak, it would increase the amount of insulin available in the early morning hours.

Thirty-one children with Type I diabetes were selected to carry out the study. After continuing the patients on four more weeks of HL/R injections, the researchers split the group into HUL/R insulin users and HL/R insulin users. The trial lasted for twelve weeks, with each patient taking an injection once before breakfast and once before the evening meal.

After the twelve week trial, the researchers concluded that young Type I diabetes patients using twice-daily doses of human ultralente (HUL) insulin combined with regular insulin can safely improve fasting blood glucose levels and lower the magnitude of the morning glucose rise. HUL/R did not improve metabolic control.