dosing question

[ROVERT81402]

Trevor is on MDI lantus/novolog. If he wants an extra snack, should I just give him one, and then deal with the high later, or should I dose for it when he eats it? I've just been playin it by ear, but I figured I better get some opinions before my MIL asks me that question, and I can't give her a straight answer. She'll think I don't know what I'm doing!
Thanks

[lisalotsamom]

I would definitely give extra novalog to cover the carbs in the snack either before, during, or right after he eats it. If you know for sure he'll eat all of it, you can inject just before, but might want to wait until after. With little ones, you never know when they'll change their minds. Then, too late once the insulin is in......you'll be chasing him with glucose, begging him to eat.

[ROVERT81402]

what if its like an hour or so before dinner, or lunch? He's has a mornin snack (15g), an afternoon on, and before bed. Both of those are 30g. Sometimes he still wants more, and I can't always takl him into meat and cheese.

[momtojess]

When Jess was on lantus/humalog ( she was only a year old though) she would eat all the time, and we would just always give a humalog shot to cover it.

of course now she is on the pump, but we still cover all her carbs (except for bringing up lows of course) with a bolus, even if she just had her last bolus an hour ago.

if you mil asks, just tell her an answer to make her happy, and then work around with it till you see what works best.

[wilf]

what if its like an hour or so before dinner, or lunch? He's has a mornin snack (15g), an afternoon on, and before bed. Both of those are 30g. Sometimes he still wants more, and I can't always takl him into meat and cheese.

Maybe get yourself some Regular insulin. It has a longer, flatter peak than NovoLog, and is known in Europe as the "party insulin" because you can inject it and then graze for a few hours..

My guess is that giving some Regular at meals might work to help cover subsequent snacks (as long as there not more than a couple of hours after the meal).

The way we do it, would for example if we're planning for say lunch followed by a party at 2 pm we'd give 1-2 Novolog (for the lunch/dessert) and in the same needle say 3-5 Regular to cover 75 to 125 carbs of grazing (between 2 and 4 pm)..

[twodoor2]

I always wait at least two hours after the last injection because of "insulin on board" and if you give two injections too close together, it might cause a low. That's just me though, I don't know if anyone else would agree. The nurse at my endo's office agrees with that strategy.

[Mom2rh]

Are you on set carbs for your meals? How many do you give him and what is your novolog dose? Divide the insulin units into the carbs and that gives you the factor to dose for extra snacks or carbs or whatever.

[ROVERT81402]

For breakfast he gets 45carbs, and lunch and dinner he gets 60. he gets 2 units of novolog, plus extra if he''s above 200(1/2 unit for every 50 over) So his carb:insulin would be 1unit for every 30carbs, right? Except breakfast would be 1unit for every 22.5 carbs?

[LantusFiend]

If you're really unsure about carb ratios, I would guestimate on the low side and correct later.