advertisement
 

  Back to Ask the Diabetes Team Ask the Diabetes Team
Question:

From a family physician in North Carolina, USA:

My son, diagnosed six months ago and still in his honeymoon, is taking 4 unuts of Lantus (insulin glargine) once a day and 1 unit of Humalog per 15-20 grams of carb. Due to fluctuations in his needs associated with the honeymoon, his requirements can change unpredictably and often. We have ordered an insulin pump which should help.

For the last month, we've noticed a trend I can't explain or understand. My son will wake up with a reasonable fasting blood glucose (e.g., 130-150 mg/dl [7.2-8.3 mmol/L]) and then eats breakfast, but, even though we cover the carbs carefully, his two- hour postprandial is 200-350 mg/dl [11.1-19.4mmol/L], indicating we weren't even close. However, later on that same day, he responds to Humalog predictably and his control is great. Despite a normal fasting before-meal breakfast blood glucose, he seems to need even more Humalog for breakfast coverage than any other meal in the day. Why would this happen?

It's an important issue because, when school starts again, we will have to make a critical decision about how to cover his breakfast so nothing bad happens at school.

Answer:

We frequently see the need to use more insulin for the morning meal. Typically the carb ratio is maybe 30-50% greater for the morning (1 unit per 10 grams carb versus 1 unit per 15 grams carb). Give that a try, but remember that you don't want to have the lunch glucose too low. Another approach, more complex carbs, but kids frequently won't participate.

As a physician -- I hope you aren't the only doctor treating him -- do have a good peds endo on the team.

LD

DTQ-20010715125648
Original posting 23 Jul 2001
Posted to Daily Care

  
advertisement


                 
  Home Return to Top

Last Updated: Tuesday April 06, 2010 15:09:24
This Internet site provides information of a general nature and is designed for educational purposes only. If you have any concerns about your own health or the health of your child, you should always consult with a physician or other health care professional.

This site is published by T-1 Today, Inc. (d/b/a Children with Diabetes), a 501c3 not-for-profit organization, which is responsible for its contents.
By using this site, you agree to our Terms of Use, Legal Notice, and Privacy Policy.
© Children with Diabetes, Inc. 1995-2015. Comments and Feedback.