My 14 year old daughter, diagnosed about a year ago, has a high blood sugar every morning. Could you answer some question? How much basal insulin can she take at night? Is it more then 20 units? Is a total daily insulin dose of nearly 60 units normal for teens?

It depends mostly your daughter’s weight. During adolescence, insulin requirements (due to the physiologic insulin resistance typical of that age) could be around 1.2-1.8 units per kilogram per day. So 60 units per day could be the right dose if your child’s weight is about 45-60 kg. Then, 20 units of basal insulin given at night could be a right dose as well. A high fasting blood sugar is a quite frequent find during adolescence. It might be useful to give the NPH insulin at bedtime or switching to Lantus (if it is available in Russia).

AS
Additional comments from Dr. Donough O’Brien:

An average insulin dose for a 14 year old girl would be about 0.8 units per kilogram per 24 hours. So, a total dose of 60 units might be a little high, but if she is getting a mixture of Regular insulin and NPH, it would be quite appropriate to be giving 20 units before supper.

The most probable reason for her high morning blood sugar is that it is a response to a low blood sugar in the very early morning. To find this out, you need to do one or two blood sugars at around 2:00 am. If these are low, the answer might either be a high protein snack at bedtime or reducing the evening insulin. You should talk to the doctor about this.

DOB