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March 20, 2004

Daily Care, Insulin

Question from Italy:

My son, three years old, was diagnosed with type 1 in November 2003. Currently, he is receiving only half a unit of rapid-acting insulin before lunch. He is in his honeymoon and he takes one shot a day with good glucose levels, about 80 to 150 mg/dl [4.4 to 8.3 mmol/L] until this last week. Now, after his afternoon nap, which is from 3 p. m. to 5 p.m. (15-17 p.m.), the glucose level is higher, 210 to 260 mg/dl [11.7 to 14.4 mmol/L]. Should I add a one-half unit of NPH insulin or one-half unit of rapid-acting insulin at lunch to improve his glucose level?

Answer:

I’d rather start gradually with the usual intensified insulin regimen based on Lantus at dinner or in the morning and Regular or an analog, such as Humalog, before each meal based on the post meal sugar levels that must be kept under 140 to 160 mg/dl [7.8 to 8.9 mmol/L]. Talk to your doctor before making any change and for further help to apply the correct insulin dosages.

MS