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Dr says no to Lantus-Stay on NPH

Discussion in 'Parents of Children with Type 1' started by Kyle's Mom, Feb 9, 2007.

  1. Chase's mom

    Chase's mom Approved members

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    My son started on Novolog and Lantus when he was dx'd last July. I would hate to find out what that Endo says about a pump????? Technology is a good thing.:D
     
  2. Big Hair Momma

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    This is the same regimen we follow. I also had concerns about the NPH and voiced those on this board, however we have had good success with this recently. Caleb is able to eat pretty much whatever he wants with a maximum of 3 shots a day. He gets NPH and Humalog after breakfast, Humalog after lunch, if needed (we never have) and we mix the Lantus and Humalog after dinner. We see a doctor at the Barbara Davis Center and she has been great. If this continues to work and keep Caleb in control, I would use this as long as possible.
     
  3. jeep_bluetj

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    And this is a key point: Use what works. I wouldn't use NPH at all except for a last resort. Stacie finds it works fine. D is extraordinarily variable. What works great for one doesn't work for others. A good endo really understands this. A poor one is of the "do what I prescribe and nothing else" camp.

    If you have good control on NPH/R, and the associated lifestyle choices are acceptble, there's no reason to change. While not common with kids, this _does_ occur.

    If you find signficant problems with NPH, then switch. As Jeff said, the science is overwhelming. There should be no endo that could argue with the data. They may argue that the D education isn't sufficient for basal/bolus, but that's just silly, IMHO. It's not that hard.

    As an aside, the cover lunch with NPH concept is a reasonable idea (to me) though. There's no nighttime NPH, so hypos at night should be less frequent and less severe. And there's not a usual injection at school. The am NPH dose is likely far less than it would be without the other basal insulin so the % change from the variability is far less than if it was the only insulin being used. The overlap may even be helpful for the common post-breakfast high. Sure, it requires a reasonably rigid timeline during the day, but a school day provides that.
     
  4. Kyle's Mom

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    Thank you!

    Thank you all for the information! I think it is time to start looking for a new endo. I am so glad I have this site to ask questions, I don't know anyone else who has a child with D and have never had any experience with T1 so being new at this and all I use this website to become more informed. The change the nurse made on Friday to his a.m. Novolog (1 unit now in a.m.) has done nothing, hit 438 at lunch today! The highs are causing him to wet hit pants and scream that he's starving all day, I feel so bad for him. I guess we are going to have to suffer through this until I can get an appointment with a new endo. Lots of great hospitals here being so close to NY City so hopefully I will find someone knowledgeable. Thank you so much again!
     
  5. Kenna's Mom

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    my daughter started on lantus and novolog and she gets four shots a day. WE are on nph for school days,she goes to preeschool three days a week. On those days when she is on nph her blood sugar is all over the place,we are switching to the pump! When we just did the lantus and novolog we had much better results.Hope this heps some,good luck.:eek:
     
  6. hallenbeckfamily

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    Chris was dx 4 months ago and started out on lantus and novolog. I only know of how this works for us. After a little tweaking over the past few months I definaltley have come to believe it gives him more freedom and less extreme hi's and low's. Its 4 shots a day 1 at each meal and lantus after dinner.I don't know what I would do with anything else,this works very well for us.~~Jennifer
     
  7. Mama Belle

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    Which doc do you see? We see Fiallo-Scharer. We'll actually be there tomorrow! :)
     
  8. Mommaof7

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    We were started with Lantus and Novolog, still using it. He gets one shot of lantus in the am and then novolog after every main meal and large snack.
     
  9. 3js

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    we started on nph/nr in may at dx.when we tried to switch to lantus/mdi, the main reason for the no was too many shots. i was thinking the other day that the endo likely thinks we are using a syringe rather than pens. with a syringe you can draw 2 insulins into one shot.

    i was told it would mean at least 4 shots a day plus snacks. well, we already give him 4 shots a day.

    could it be that? i am not switching endo`s over this. but i was also told we would eventually go to mdi and a pump next may so i`m ok with it.

    if you can find out exactly what he has in mind it may help you to decide.

    good luck!!!! it can be frustrating even when you love your dr. can i ask, are you in canada? nph seems to be prescribed more commonly here than in the us, where it is unusual.
     
    Last edited: Aug 8, 2007
  10. madde

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    How do those who use lantus and have kids in school cover lunch time. Where we live their is no one available to give shots at her school. I would not be able to leave work everday to dose & give shot. Our county has one school nurse. And she covers about 8 schools.

    I just don't understand how I could work around all the shots with lantus.
     
  11. Mommaof7

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    Since we're new to this I don't know how it works, so on NPH you don't give shots after meals?? We homeschool so giving shots aren't an issue.
     
  12. Caynuns mom

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    Our Endo was hesitant when I asked about Lantus too but he did not turn us down on it, he just explained why he thought it better to stay on NPH and I agreed. Yes its old school but sometimes for some people old school is the best way to go.
     
  13. Josh's Mom

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    Josh has been on Novolog / Lantus since the beginning ... he started with 15 units of the lantus every evening, but with honeymooning, he is now down to 13 units.
     
  14. Treysmom

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    We switched endos for this reason. We wasted 6 months on NPH.UGH !!!!
    We then changed endos in March, he put us on Levimer and Novalog. Then in June we went to the PUMP:D
     
  15. madde

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    No, on NPH it is a shot in the morning, and sometimes in the evening. Depending on child. NPH peaks around lunchtime, so no shot is required.
    The tricky thing is that they must eat a certain amount of carbs. With Madison it is between 35 & 50 to maintain steady bs level.
     
  16. ange_mom

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    David is on lantus/humulog. We give him his lantus before he even wakes up in the morning. Since he is honeymooning, his body seems to make insulin at night so if the lantus is running out, that helps him not have lows. Once the honeymoon is over, I imagine we will give it to him at night.
    Anyway, one shot while he is still sleeping is no big deal. I would get a new endo.
     
  17. Twinklet

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    My daughter was diagnosed at age 8 and in 2nd Grade. She started on MDI with Lantus and Novolog. For the first couple months I had to go to school to give her a shot. She got brave after that and started giving her own shots using a Novolog pen. She did have to call me with her BG so I could calculate the correction dose for her. She was permitted to take a cell to school and call me from the classroom for this purpose.

    No one at her school is trained to give insulin injections at all, so this is what we did.
     
  18. DylansMum

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    Dylan has just started on Lantus last week, because when he was on Protaphane he was too erratic in his readings, as in they were too high, too low, and all over the place, since he has been on Lantus, his levels are levelling out and it is great, he has just Lantus in the mornings with his Acrapid and then only Novarapid at night, so he is only on 3 jabs a day at present.
    He has the insulin pens and loves them.

    Lantus is going great so far!!!
     
  19. liasmommy2000

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    Lia was on Lantus last year and her school district doesn't have any nurses. But it's a public school and they need to make accomodations when necessary to make sure kids get the medicine they need etc. So I trained the secretaries (and an aide) in the office to give shots. They are the ones who do all medical stuff when needed for the students. I trained them on how to draw up and administer the insulin. I send carb counts with her foods and the aide watches over her at lunch to see what she eats. They call me and tell me how many carbs she ate and I tell them how much insulin to administer.

    I guess this depends on how willing the staff is to do this. The principal at Lia's school has always been quite up front telling me they will do whatever they possibly can for her. And the secretaries feel the same way and lucky for me they are very intelligent and caring ladies who not only give Lia her shots, but really watch out for her in every way. They really care about all the kids. Now if they or the principal weren't willing to do this and fought it, I would have been very reluctant to push it and perhaps found another option.

    This year Lia is on the pump, so it should be even easier for them.
     
  20. AlisonKS

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    I'll be in the minority here, my son goes to Texas Childrens Hospital-so it's not some redneck idiot doc doing this, but rather a team of knowledgeable staff that had us switch from lantus to nph. I just had to have faith that the team of endicrinologists knew what to do-and it worked. If not, I would have seeked a different opinion.
    Tony does better on it, less lows and less highs. It took a few days for it to be noticeable but it's working better for us-every child is different. Yes, we have to eat meals at certain times but it's not that hard for us, Tony was on this plan for months before diagnosis since we lived with my grandparents (whose late daughter was on nph-she was diagnosed 60 years ago) and they stuck to the meal plan. So maybe that's why.
    He gets a shot of nph and novolog in the morning, the nph peaks at lunch and he's covered. He gets the same insulins in the evenings too. For the past couple of days he's been within range 90% of the time-dang cold threw us off for the week earlier.
     

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