If a child is on pre-mixed insulin and his blood sugar averages 240-300 mg/dl [13.3-16.7 mmol/L], how many units of insulin should he be given?

We don’t recommend correcting doses using pre-mixed insulins, only with Novolog or Humalog. We usually recommend an average of 1 unit/50 points correction, but this needs to be individualized based upon body weight, total insulin dose/day and sensitivity factors. You should go back to your diabetes team and ask them this question since they know your child the best — or you should do some detective work at home and see what works for your child.

SB

[Editor’s comment: It sounds to me like this child may need a change in overall dosage or regimen, rather than a correction factor. The appropriate dose and regimen would depend on the overall pattern of blood glucose levels (i.e. what time of day the highs are occurring). You need to do some frequent blood glucose monitoring (at least before meals and at bedtime, preferably also including some two-hour after meal and nighttime readings) to determine that pattern and then review the log with your child’s diabetes team to revamp his treatment plan. If your child is not currently being followed by a pediatric diabetes team, ask for a referral to one.

SS]