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Question:

From Milwaukee, Wisconsin, USA:

Our 3 year old daughter is a picky eater, and sometimes does not eat very well. She is taking Regular and NPH at breakfast and dinner. Would changing her from Regular to lispro give us more flexibilty in introducing new foods without endangering her glucose levels, since I've heard it can be given after a meal?

Answer:

This is an issue you should discuss with your child's own pediatrician. Yes, lispro insulin [Humalog®] can be given after meals as it works faster than Regular. This theoretically could give you more flexibility in matching the insulin to the amount of food eaten. I say "theoretically" as in my experience, it is very variable how much flexibility each child can get in trying to match the insulin to food, as even lispro doesn't work exactly like the body's own insulin and there are other factors that affect the blood sugar besides insulin and food. In young children who do tend to eat approximately the same amount of carbohydrate each day at the same meal, blood sugars can vary from day to day even when matching the same amount of insulin to the same amount of food. I still feel ideally, you should try to have a basic meal plan with day to day consistency and try to match the insulin to the basic meal plan. Of course, this is not always possible, especially in young children, so giving all or part of the fast acting insuln as lispro afer meals gives the parents some flexibility in changing the insulin dose when the child is unable or unwilling to follow the basic meal plan.

I would not be too concerned about introducing new foods at this age as long as your child is eating reasonable healthy foods. If at all possible, you do not want to argue about food. If you want to expose your child to new foods, you might want to give him only bite size pieces to try at first so he can decide whether or not to try the new food. If it is just a "biteful", it probably won't make much difference in diabetes control if your child does or does not eat the new food. Of course, you should have a standby food you know your child likes. If your child likes the new food, you can always offer it in larger quantities as permitted by your child's meal plan in the future. Better to have the child looking forward to new foods than refusing to try them.

TGL

Original posting 3 Dec 1998
Posted to Insulin Analogs

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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