Lg Cwd
Need Help

Submit your question to our team of health care professionals.

Current Question

See what's on the mind of the community right now.

Meet the Team

Learn more about our world-renowned team.

DTeam Archives

Review the entire archive according to the date it was posted.

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.