March 28, 2003
Insulin
Question from Wilmington, North Carolina, USA:
My seven year old daughter is taking 11 units of NPH with 2 units of Humalog in the morning and 8 units of NPH with 1 unit of Humalog in the evening and eats up to 150 grams of carb each day. What would be a normal amount of NPH and Humalog to give a 53 pound seven year old? It would be great to have a scale, is there one?
Answer:
Giving insulin twice a day is an old fashioned way of providing insulin. It produces more problems with middle of the night hypoglycemia and often does not provide adequate pre-breakfast glycemic coverage.
General guidelines for insulin are on a weight basis — in kids before puberty from 0.5-0.8 units/kilogram body weight/day. In puberty, this often goes up to the 0.8-1.5 units/kg/day range for a few years. After puberty, the dose frequently comes down very significantly.
SB
