July 24, 2003
Daily Care
Question from Phoenix, Arizona, USA:
We very recently moved to Phoenix from Michigan, and since the move, my eight year old daughter’s numbers have been terrible, often 250 mg/dl [13.9 mmol/L]. and higher. She is on Lantus with Humalog, and used to use an insulin to carb ratio of 1:15, and now I find myself changing to 1:10 which seems like quite a large increase in insulin. Her insulin was constantly refrigerated on the move to Arizona so I do not think that has been compromised. We never had to worry about heat in Michigan and did not keep the pen and vial that we were actively using at the time in the refrigerator.
Could this just be an adjustment in climates for her? Should we keep her insulin in the refrigerator? We are waiting a referral to a pediatric endocrinologist (her doctor is on vacation), but until then I would like feedback on her increase insulin need.
Answer:
Heat is an enemy and in Phoenix this time of year it is hot so insulin can go bad just in the air. I doubt the Lantus is bad if it has been in the fridge. Use the higher carb ratio and think about the correction factor too. Are you giving insulin for the glucose level at the meal in addition to the carbs? It’s also likely some stress is at work here.
LD
