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October 9, 2002

Daily Care

Question from Buffalo, New York, USA:

We recently switched our two and a half year old son (diagnosed at 13months) to Humalog at meals with 5 units of Lantus in the morning, which is keeping his glucose readings within a better range, but he gets hypoglycemia between 4 am and 7 am. I try to give him a protein at his 8 pm snack along with his 1 carb. I hate to lower the Lantus dose because his numbers are so good. Any suggestions?

Answer:

Five units seems like a lot for a 2 year old. I might suggest splitting the Lantus (insulin glargine) into two doses — 3.5 units in the morning and 1.5 units at bedtime as a start. Discuss with your son’s doctor.

LD
Additional comments from Dr. Stuart Brink:

I agree that switching to a lower dose of Lantus seems reasonable. Sometimes splitting the dose to some at bedtime and some in the morning will also help. Other times, we use Lantus at bedtime rather than morning.

You need to experiment with different times while doing a lot of blood glucose readings and then review these with your diabetes team to see what works best. Each child is different.

SB