Question for Lantus/Humalog MDI parents

[KTurner52]

We are new to this regimen and just when I think I figure it out something else throws me..here's tonight's dilemma..
We finished dinner late so my daughter got her Humalog about 7:45. She absolutely won't go to bed without her snack (frozen yogurt) and per our CDE are supposed to wait about 3 hours between Humalog doses. I can't keep her up till 10:45 on a school night so...??? I decided to give her her shot right after her snack not knowing what else to do, so that made the interval more like 2 hours. I will check her soon, but for the future I was wondering how you handle this with your kids? Besides getting dinner on the table sooner:)
Thanks,
Kelli

[Amy C.]

I always gave the amount of insulin needed for the food. What you don't want to do is test and give a correction for a high blood sugar at the same time. Of course she will be high from dinner. That is insulin stacking, because the supper insulin is still working and a correction is not needed. If your daughter had eaten her yogurt with dinner, you would have given the correct amount of insulin to cover it. If there is a 2 hour time span between portions of the meal, you still need to give enough to cover it.

I can speak to this because my son was on Lantus/Humalog for 5 years.

[KTurner52]

That makes sense. I didn't even think about a correction because she tested at 147 before her snack. I would have been even more confused if a correction had come into play. Anyway, I gave her the normal dose to cover her snack, and from the 147 it looks like we covered dinner pretty good too. Just wondering Amy....since you did this regimen for 5 years, was your child unwilling to consider pumping for awhile? My daughter just says NO whenever the word is mentioned. I really hope she will change her mind one day, but she is stubborn!

[Nancy in VA]

When you dose before the 3 hour mark, you only dose for food. You could dose for food every hour if you wanted, but at some point you just need to see if you are giving the right doses.

My favorite thing about Lantus and Humalog was getting rid of that bedtime snack - you don't need it anymore on Lantus - you don't need any food on any schedule with Lantus and we LOVE that!

[KTurner52]

I just can't convince my daughter that she doesn't need that bedtime snack anymore!! She says she NEEDS her ice cream. I have quit the morning snack, and she rarely has an afternoon one, but she is hooked on her bedtime snack. Thanks for your help! BTW--I am absolutely loving this Lantus/Humalog. Losing that strict schedule was like getting a little bit of our old life back!

[Mrs. Russman]

Just to second, we give insulin to cover carbs eaten anytime. sometimes two at dinner, "Mom I really want another... even if it means another unit of insulin." Our CDE is Type 1, and he said he will sometimes shoot up for dinner and then decide on dessert so shoot up for dessert.

I seldom get dinner on the table 3 full hours (or even two) before bedtime.

[Heather(CA)]

I always gave the amount of insulin needed for the food. What you don't want to do is test and give a correction for a high blood sugar at the same time. Of course she will be high from dinner. That is insulin stacking, because the supper insulin is still working and a correction is not needed. If your daughter had eaten her yogurt with dinner, you would have given the correct amount of insulin to cover it. If there is a 2 hour time span between portions of the meal, you still need to give enough to cover it.

I can speak to this because my son was on Lantus/Humalog for 5 years.

Exactly, I second what Amy said;)

[Amy C.]

Just wondering Amy....since you did this regimen for 5 years, was your child unwilling to consider pumping for awhile? My daughter just says NO whenever the word is mentioned. I really hope she will change her mind one day, but she is stubborn!

The reluctance came from his father and me. Philip wasn't going to try without our encouragement. I felt that he could have good control on Lantus/Humalog, and he did. He did especially well when I broke the Lantus up into two shots.

He went on the pump because it became increasingly difficult to manage the shots on over night adventures where I couldn't be or didn't want to be there (mostly Boy Scout campouts). Philip had a hard time managing the tasks of pulling up the insulin when all he wanted to do was be with his friends. It was pretty easy when at home when I was there to remind him. At 12, he started doing more outside the house.

I could never get his A1c below 7.3 on shots and thought the pump would be an easier tool to use. His A1c has ranged from 6.9 to 7.1 on the pump. The biggest draw is that it is incredibily convenient.