My 10 year old son is on three shots per day of Actrapid [Regular] and Insulatard [NPH], but recently his pediatrician advised us to switch to Lantus once daily instead of the Insulatard in addition to three shots of Actrapid with meals. However, I read that Lantus regulates the rate of growth of children. Could you give me your opinion?

I can find no clinical evidence to support the idea that Lantus (insulin glargine) interferes with the normal growth pattern, and certainly this long acting insulin has come to be used very widely in the U.S. I rather think that this idea may have started from the observation that glargine, like insulin, gets attached to IGF1BP, Insulin like Growth Factor-1 Binding Protein, and might therefore be supposed to interfere with the action of that hormone. However, there have been several studies that have shown the interference of glargine with IGF1BP is quite small and certainly not enough to contraindicate the use of glargine.

If you do switch your son to Lantus, you might also talk to his pediatrician about switching at the same time from Actrapid to NovoRapid. The latter is a very quick acting insulin which, like Humalog, can be given at meal times with the dose adjusted to appetite and premeal blood sugar.

DOB