May 6, 2004
Daily Care, Insulin Analogs
Question from Pennsylvania, USA:
My four year old son was diagnosed a little over two years ago. He weighs 45 pounds and takes about 12 units per day. Four and a half of those are Lantus with Humalog for meals. My concern is extra activity with summer arriving and low blood sugars. I would like to begin decreasing his Lantus, but our pediatrician states we should just decrease Humalog. My problem is at night. Even with a large mixed snack, he will still drop and I must continually give juice. He receives his Lantus at 5 p.m. I did try giving Lantus in the morning, but the blood sugar started to rise and I find I have better control throughout the day when we start with a normal blood sugar. His A1c is 6.0 so we keep pretty tight control and I would like to continue to without lows any thoughts on this matter.
Answer:
I agree with your pediatrician on not to decrease your son’s Lantus dosage whilst I’d try to give it to him sometime later, the same dosage, perhaps at bedtime and only in the buttocks in order to better stabilize its absorption. If low blood sugars continue, then I’d start to decrease preprandial Humalog dosages.
MS
