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August 22, 2006

Insulin

Question from California, USA:

How long does it take for the insulin to work to lower one's blood sugar? My son been on it for a week and his sugar is still high.

Answer:

Your question is not really so simple. It depends, in part, on which types of insulins your son has been placed on.

Hopefully, you have met with Certified Diabetes Educator (CDE) and a pediatric endocrinologist to review how different types of insulin begin to work at different times and also have different times for their maximal effect (“peak effect”) and different durations of time that they work.

There are fast-acting insulins (e.g.”Regular” insulin), long-acting insulins (e.g. Lantus and possibly Detemir insulins), intermediate- acting insulins (e.g. NPH and probably Detemir insulins), and very rapid-acting insulins (e.g. NovoLog, Humalog, and Apidra insulins). Furthermore, the blood glucoses will also be influenced by meal intake and daily activities/exercise.

Finally, you have hopefully been told that with proper balance of insulin, meal-planning, and exercise, you should expect your child to enter a phase of relatively easy and good diabetes control called the “diabetes honeymoon.”

I’d say that with good attention to the above, the diabetes honeymoon typically begins within two to six weeks of initial treatment and lasts about one to one and a half years with good attention to on-going insulin adjustments, meal-planning, and exercise.

Your question is a very good one and very basic! You should learn as much as you can about basic diabetes management. I would strongly suggest that you have a few sessions with a CDE who works with children. Your pediatric endocrinologist can probably guide you to someone in your area.

I’d guess that if you are still seeing persistently high glucose levels during this first week, you should contact your pediatric endocrinology office for an insulin adjustment.

DS