June 4, 2003
Daily Care
Question from Jessup, Maryland, USA:
I am 39 years old, weigh 150 pounds, and I have had diabetes for 27 years. Recently, when I was switched to a Lantus with Humalog regimen, my doctor gave me instructions about my doses without any blood glucose data. This actually works rather well, but I was recently comparing notes with a 25 year old friend who has had diabetes for 11 years, and weighs, and her doses are quite different.
She is taking twice as much as I take for food count, one-quarter more as a correction factor, and her Lantus dose is significantly lower than mine. Why is there such a difference, particularly with regard to the Humalog? Is it age? Length of time with diabetes? Gender?
Answer:
You need to be very careful when sharing notes with other patients regarding diabetes. Each individual has their own characteristic requirements. For instance, some patients are more insulin resistant than others and require a larger dose. This has to be determined on an individual basis.
Issues such as weight, medications, genetic predisposition, activity, other illnesses, and insulin regimen may have a lot to do with different requirements for different people. Your physician may have been able to switch your insulin regimen knowing what your requirements were before the switch. This is a common treatment decision.
JTL