Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
March 14, 2004
Daily Care, Insulin Analogs
Question from Redding, California, USA:
My three-year-old daughter was diagnosed last July with type 1 diabetes. We were comfortable learning about this disease in her honeymoon period, and we had a fantastic diabetic nutritionist to help us on our way. About a month ago, we were told to start giving our daughter one to two units of Lantus every evening to ward off highs after breakfast (170-180 mg/dl [9.4-10.0 mmol/L]).We were told this would be helping her pancreas last a little longer. Her blood glucose has not gone higher than 200 mg/dl [11.1 mmol/L] in a long time. We have NovoLog for when that happens. Lately, after meals, her blood glucose has been climbing back up to the 180 mg/dl [10.0 mmol/L] range with two units of Lantus given each evening, however, some mornings, not consistently, we've done a morning check to find she's at 50-60 mg/dl [2.8-3.3 mmol/L]! Our diabetic educator retired last month and there is no one else in our town that sees children. Do we increase the Lantus and wake her at 4 a.m. for a snack? Is the 180 mg/dl [10.0 mmol/L] range after breakfast necessarily a bad thing?
I would suggest either a bedtime snack, enough to keep her blood sugar around 100 mg/dl [5.6 mmol/L] in the morning; the shot of Lantus in the morning because it is not clear that the evening shot will last all day; or split the Lantus dose, taking some in the morning and some in the evening. I would try the snack option first, and if that doesn’t work, try the other options, in order. I agree that you need to keep that morning blood sugar okay, not high or low.