September 22, 2003
Insulin Pumps
Question from Las Vegas, Nevada, USA:
My four year old son was diagnosed with type 1 diabetes when he was 17 months old and has been on a pump with diluted Humalog for about four months. At the time he went on the pump, his doctor told us never to bolus more than once within a two hour period. However, his new endocrinologist says he can bolus every time he eats, no matter how often. The proximity to the last bolus is irrelevant. Aside from a correction bolus, how often can we safely bolus?
Answer:
You can bolus whenever he eats. However, you don’t want to correct him more often than every three to four hours and will need to not do a correction based on a blood sugar obtained after he’s been eating.
In our practice, we only have very young children on pumps give full corrections at breakfast, lunch, dinner, and a “1/2 corrective dose” at bedtime snack. Their Humalog or NovoLog tends to have effects at least up to three to four hours after it’s been given.
LAD
