March 23, 2000
Question from San Antonio, Texas, USA:
I have an 8 year old son who has been insulin dependent for 3 months. We have changed his morning Regular insulin dosage per doctor’s order twice since, reducing it by one unit each time (from 4R/7N to 2R/8N, for a reading of 70 to 180). What can be done about before lunch blood sugar readings of 68 and below? His breakfast consist of 3 carbohydrates (15 grams) each. Does a high metabolism play an important role in dosage maintenance? And if so, what and how do we get through the honeymoon phase without continuous changes in his diet and insulin regimen?
A low blood sugar at noon can typically be corrected by reducing the morning Regular (R) insulin or adding a mid-morning snack. Making small adjustments to insulin dosing is frequently needed to respond to high and low blood sugars and especially in response to trends in blood sugars (for example, frequently being low at lunch). Certainly every person metabolizes insulin differently and choosing the correct type of insulin is an important decision that your diabetes team can help you with.