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Question:

From Kent, Ohio, USA:

My 11 year old daughter was diagnosed two years ago. She weighs 100 pounds and runs a blood sugar of 160 to 220. She is very active, however she loves to eat! She is on 8 Humalog/16NPH at 7 A.M., 7H at 4:15 P.M., and 3H/17N at 8:30 P.M. Is this dosage reasonable? Also, I am more familiar with sliding scale like in the hospital but her doctor says that is the "old fashioned" way to do it. Do you have any thoughts on this?

Answer:

Without knowing your daughter's clinical picture we can't assess her insulin dose or regimen. There are many approaches and ways. When I assess a child's insulin regimen, some of the things I would take into account (not necessarily in order) would be: her rate of growth, pubertal status, eating patterns, blood glucose monitoring results, rate of hypoglycemia, hemoglobin A1c, physical exam, and psychosocial status. I'd recommend that she be followed by a pediatric diabetes team, if she's not already.

With respect to the "sliding scale" question, I'd talk to your diabetes team. This is also an individual issue. A common approach would be to look for patterns by time of day to adjust the insulin to prevent highs and lows. Also many providers would give you a simple guideline on day-to-day adjustment of the short-acting insulin [Humalog or Regular] based on food intake, exercise, and blood glucose results.

LM

Original posting 12 May 1998
Posted to Insulin

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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