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Question: From Rome, Italy: My 13 year old daughter, who has had type 1 diabetes for about two and a half years, is using Lantus as basal insulin, with NovoRapid for her meals. We give her Lantus at 8:00 pm so I can control her blood sugar at 11pm (when Lantus starts working) and give her 1 unit of NovoRapid if she is over 150 mg/dl [8.3 mmol/L] or 2 units if she is over 200 mg/dl [11.1 mmol/L]. We control her wake-up blood sugar quite well, and she is doing well till 5:00 pm when her blood sugar rises suddenly to over 200 mg/dl [11.1 mmol/L] which means that the Lantus is working just 18-20 hours. To cover the "insulin-hole" she gets a snack with a shot of NovoRapid. Her endocrinologist suggested to give her the longer lasting Actrapid for lunch to avoid another shot at 5:00 pm, but everything I read says that Lantus has to be used with NovoRapid so I wonder how to solve that problem. Answer: Your daughter would greatly benefit from a mid-afternoon small (1-2 units) injection of any fast-acting insulin with no snack unless she needs it. This is a very good approach aimed to fill the basal rate gap that occurs late in the afternoon and causes the rise of blood sugar. The endocrinologist's advice of your is also a good one, and it's worth a try because the Actrapid (Regular) lasts longer than analogs and may control the mid-afternoon rise better thus avoiding the 5:00 pm shot. In my experience, your daughter might also greatly benefit in terms of blood sugar stability from a later (bedtime) injection of the Lantus (insulin glargine) perhaps at a larger dose for a more stable plateau over the 24 hour period. MS [Editor's comment: I am unaware of any recommendation from Aventis about what short-acting insulin should be used with Lantus. WWQ] DTQ-20030107050855 Original posting 3 Apr 2003 Posted to Daily Care

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			Jump to a new section --[ Getting Around ]-- Home Page What's New Privacy Policy Search --[ People ]-- Family Support Network Adults with Diabetes Care Photos Chat Rooms Conferences Kids with Diabetes Parents Parent Humor Scholarships and Financial Aid Grandparents Humorous Tidbits Jobs Mailing Lists CWD Forums Poetry and Art Videos Polls Quilt for Life Surveys Blogs --[ Clinic ]-- Ask the Diabetes Team Alternate Site Testing Alternative Treatments Care Suggestions CWD Español Diabetes Basics Diabetes at School 504 Plans Diabetes Camps Diabetes Dictionary Insulin Pumps Nutrition Podcasts Presentations Products Product Marketplace Sports Studies Warning Signs --[ Sources ]-- News and Information Diabetes Advocacy Links to Other Web Sites Press Releases Regional Information Services Support Groups --[ Feedback ]-- About CWD Advertise Awards Contribute Your Experiences Disclaimer Letters to the Editor Logos and Linking Share our Brochures

Last Updated: Tuesday April 06, 2010 15:09:42
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