Our 12 year old son has had trouble with lows at night and waking up high. It’s so hard to give enough insulin at night to stop the high in morning, without going low in that 2-3 am insulin sensitive period. We have heard of glargine, the new long lasting insulin (coming soon to Canada), and we wonder how this insulin is working for young boys. How is it best used? How does it give sustained release with no peaks? How hard is it to get used to using in conjunction with Humalog at meals?

Lantus (insulin glargine) has been found to work well in children and to significantly reduce nocturnal hypoglycemia. It is steadily released without peaks throughout the 24 hours, and these properties are due to amino acid changes in both the chains of synthetic insulin which makes it soluble in weak acid, but which forms a fine slowly released precipitate at neutral body pH.

This insulin is usually given at bedtime because the morning blood sugar level after several hours of fasting then gives a good idea of basal insulin need. For after meal blood sugar rises, it is usual to use Humalog (which can in fact be given immediately after the meal so that the dose can be modified according to appetite and the pre-meal blood sugar). Long acting insulin needs are usually less than with NPH after the change to Lantus, but you will need to work out the details with your son’s doctor.

DOB