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From Kent, Ohio, USA:

My 11 year old daughter was diagnosed two years ago. She weighs 100 pounds and runs a blood sugar of 160 to 220. She is very active, however she loves to eat! She is on 8 Humalog/16NPH at 7 A.M., 7H at 4:15 P.M., and 3H/17N at 8:30 P.M. Is this dosage reasonable? Also, I am more familiar with sliding scale like in the hospital but her doctor says that is the "old fashioned" way to do it. Do you have any thoughts on this?


Without knowing your daughter's clinical picture we can't assess her insulin dose or regimen. There are many approaches and ways. When I assess a child's insulin regimen, some of the things I would take into account (not necessarily in order) would be: her rate of growth, pubertal status, eating patterns, blood glucose monitoring results, rate of hypoglycemia, hemoglobin A1c, physical exam, and psychosocial status. I'd recommend that she be followed by a pediatric diabetes team, if she's not already.

With respect to the "sliding scale" question, I'd talk to your diabetes team. This is also an individual issue. A common approach would be to look for patterns by time of day to adjust the insulin to prevent highs and lows. Also many providers would give you a simple guideline on day-to-day adjustment of the short-acting insulin [Humalog or Regular] based on food intake, exercise, and blood glucose results.


Original posting 12 May 1998
Posted to Insulin


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Last Updated: Tuesday April 06, 2010 15:08:58
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