My four year old son was recently changed to Lantus at night because of nighttime lows, and now he’s on NPH with Regular in the morning and Lantus at night. Is it okay to mix NPH and Lantus during the day?

The insulin doses should be prescribed according to known effects of insulin and based upon frequent blood glucose pattern management. We have many patients using bedtime Lantus and either breakfast or lunchtime NPH because this provides the type of insulin coverage they need. There are others who need Lantus twice a day, and still others who seem to need Lantus just in the morning instead of the evening.

However, all such decisions should be made with close collaboration and discussions with the diabetes team supervising care after reviewing blood glucose profile data. There is no one “right” insulin regimen, but goals should be the best glucose control possible with the least amount of hypoglycemia for that person.

SB

[Editor’s comment: Lantus cannot be mixed in the same syringe with any other insulin. However, it might be conceivable to give that combination as separate injections.

SS]