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From Misawa AFB, Japan:

My 4-year old daughter diagnosed 4 months ago with Type 1, often has high sugar levels at dinner (300+). Her afternoon snack is light and 3 hours prior. Her lunchtime sugars are low so I don't want to increase the morning NPH. On these occasions, she receives 1/2 unit of Regular along with her NPH before dinner. (She receives 7 units NPH at 6 A.M., 2 units NPH at 6 P.M.; she weighs 18 Kg). She finishes dinner at 7 P.M., and is in bed by 8 P.M., so no bedtime snack. If she has received Regular insulin at dinner, I check her while she's sleeping at 9:30 PM and she's usually dropped to the low 60's. What can I do at this point? I can't get her to really eat or drink anything. Would putting some frosting in her mouth raise her sugar enough to sustain her?


In general we don't offer specific dosage advice which should be obtained from your diabetes team. However, a couple of observations: your daughter's pre breakfast insulin is very early (6 A.M.) and I wonder if you would have better control at lunchtime and before dinner if the NPH was given a bit later (e.g., 8 A.M.) but perhaps this wouldn't fit with your schedule. Have you tried reducing the morning NPH because the lunchtime lows may reflect that the dose is a little high. Your response to these lows (extra carbohydrate) may be part of the reason for the highs before dinner.


Original posting 23 Oct 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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