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March 3, 2005

Daily Care, Insulin

Question from Columbia, South Carolina, USA:

My 10 year old son takes nine and a half NPH and three Regular in the morning before breakfast, then waits 30 minutes before eating. He is a picky eater and he only wants to eat one cup of Cheerios with one cup of milk, 3 ounces of orange slices, and one piece of toast. His numbers were high at lunch time a lot so his morning snack was reduced. He had been eating two Triscuits, then none. Now, he only eats half a granola bar at 9:30 in the morning, which is two hours after he finishes breakfast. He checks his blood sugar before lunch because his class eats lunch at 11:45. I don't understand why his blood sugars were high at lunch, but are now low. Where is the happy medium?


Your son would likely benefit from a revised insulin dosing schedule. I would talk with your diabetes team about switching to Lantus insulin for his basal insulin and a rapid acting insulin such as Humalog or NovoLog for his carbohydrates and high blood sugar dosing. You’ll likely have better success with fewer labile blood sugars and improved control.