My seven year old daughter, who was diagnosed with type 1 diabetes a month ago, is actually doing quite well and is following her regimen without much complaint, but my husband and I have an important appointment that we have to be at with our older son which will last most of the day and is quite a drive from our house so we would miss her dinner shot (usually given at 6:00 pm) and her bed shot (usually given at 9:00 pm). Is it possible for us to have her wait for her bedtime shot (we probably would be back home around 11:00 pm)? Our neighbor is a nurse and offered to give her the dinner shot, but we have no one to give the last shot of the night. (Since this is so new we have yet to find anyone willing to learn).

I am going to assume that the 6:00 pm. injection is Humalog and that the 9:00 pm insulin is Lantus (insulin glargine), in which case I would try to finesse this by delaying the bedtime dose until 10:00 pm on the day before your trip doing a blood sugar just to check whether the evening snack should be reduced (assuming your daughter still gets one). The day of your trip would be another 25 hour span for glargine needing perhaps a small reduction in the Humalog on the following morning, The shot should be all drawn up so that you can give it as soon as you get home.

I would be concerned though about having a back up plan if something goes wrong e.g. a breakdown or traffic jam. Could your daughter perhaps ‘sleep over’ with your neighbour? Do you have a cell phone? Obviously, there are many variations on this theme, but I do think there needs to be such a plan or one of you should stay home.

DOB

[Editor’s comment: If your daughters bedtime insulin is NPH, Lente, or Ultralente, the same principles would apply.

SS]