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March 4, 2000

Insulin

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Question from Arizona, USA:

My 14 year old son is a freshman in high school and was diagnosed with type 1 diabetes about a year ago. He takes three shots of insulin a day; Humalog and NPH in the morning before breakfast, Humalog before dinner, and NPH before bed. He averages about 10 units of Humalog and 22 units of NPH before breakfast, and 4 units of Humalog before dinner. He eats around 70 to 75 grams of carbohydrate with each meal. Why does he require so much more Humalog before breakfast than he does before dinner? His blood glucose levels have been good (HbA1c levels of 6.5 to 7.5%).

Answer:

From: DTeam Staff

That’s a lot of carbohydrate to have for breakfast but I don’t know how big your son is. However, the insulin dose required at breakfast time is a reflection of the fact that the blood insulin level has fallen overnight and needs pushed up again to cope with food intake.

KJR