My 10 year old son uses a combination of Humalog and NPH before breakfast and at supper. Because of the action of Humalog, how necessary is it for him to have an additional dose of Humalog to cover the lunch meal?

This all depends on the strategy your diabetes team has chosen to assist you with your son’s blood sugar control. Most of the time, you will have more success controlling blood sugars by covering carbohydrates with Humalog and using a longer acting insulin such as NPH, Lente or Ultralente insulin. This would typically include an injection of Humalog at lunch. However, it is also important to do what works, and if you are having success using your strategy (low Hemoglobin A1c and few lows or highs), then your strategy may be working well and there may be no need to change. Your diabetes team should be able to help you choose the best strategy for your son!

MSB