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November 14, 2004

Insulin Analogs

Question from Chile:

Some other parents and I have been asking and researching, with no result, the consequences of using more insulin (Total Daily Dose-TDD) than the amount that is supposed to be used relative to the weight of the child. If there is a problem, what is the percentage of additional insulin, over the TDD, that would be considered dangerous, and why? Particularly, I am concerned about the comment that Detemir would mean more units of insulin than Lantus, which is what our endocrinologist has told us and what I have read.

Answer:

It is very important to understand that every patient is different and that insulin requirement is therefore an individual thing. However, most toddlers, after the honeymoon period, will require approximately 0.9-1 units per kilogram of body weight. It is not my experience that the doses of Lantus, Detemir or NPH are actually terribly different, but what matters is the result, i.e. the blood sugars. Your team should be able to guide you on what dose is working best.

KJR