Our four year old daughter was just diagnosed with type 1 two weeks ago. She’s 44 inches tall and about 42 pounds. How many points, on average, does one unit of NovoLog drop her blood sugars? I was told that it was about 120 points. Is it based on the individual? When she is hypoglycemic, at about 64 mg/dl [3.5 mmol/L], how many carbohydrates should she consume to bring her levels back up to 100 to 150 mg/dl [5.6 to 8.3 mmol/L]? It seems as if I’ve been giving her too much because her numbers shoot up to 360s (mg/dl) [about 20.2 mmol/L]. After that, I gave her one and a half units of NovoLog and her numbers went back down to 64 mg/dl [3.5 mmol/L], then the entire cycle begins again. She is taking five to six units of Lantus at bedtime. Does the Lantus have to be given three hours after her last dose of NovoLog, or just after the NovoLog peaks?

The degree of insulin “sensitivity” is quite individualized and will change over time in that person, based on weight, concurrent medications, puberty status, illness, and others. There are a number of “rules of thumb” to help determine one’s insulin “sensitivity factor, ” but I find what works just as well as others is experience. If you find that a single unit of fast-acting insulin tends to drop the glucose by 50 instead of 120, then that is your sensitivity factor.

A confounding issue is trying to address insulin sensitivity relative to different foods. This is often referred to as the glycemic index. Certain foods will increase the glucose level more dramatically than others. And if that’s not confounding enough, different foods may affect the intestinal absorption of foods. A common is example is that fatty foods tend to interfere with the prompt absorption of foods. People with diabetes often note that foods such as pizza are harder to estimate glucose levels and insulin dosing.

These are issues to review and individualize with your own diabetes team and nutritionist.

DS
Additional comments from Jeff Hitchcock, CWD Founder and Editor:

For more information, see our page about Lantus. You can also search this web site for more information about Lantus.

JSH