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Insulin Question

Discussion in 'Parents of Children with Type 1' started by CarrieP, Apr 9, 2007.

  1. CarrieP

    CarrieP Approved members

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    The support group I run just got a family with a newly diagnosed diabetic 10 month old baby with Down Syndrome. The doctor has the baby on 3 units of Lantus and then Humalin-R, diluted to 1/4 strength. Has anyone even heard of a doc putting someone on regular insulin anymore??? They are having such a hard time with lows in the 40s REGULARLY. I didn't want to tell them that it was a bad regimen, but this is the same doc that started my little one on NPH. This is such a young family and I just feel like telling them to demand something else!!! This doc won't help his patients to learn to dilute their own insulin, so it may be that the Humalin-R is the only one that comes 1/4 strength??? I told them to go to CWD-FFL in July to learn about all the options available to them....

    Any thoughts on this regimen???

    CarrieP
     
  2. Flutterby

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    I don't know anything about the humalin-R..but 3 units of lantus in a newly dx 10m old is a lot.. when Kaylee was dx at 2 (almost 3) she was on 1 unit of lantus (and then novalog for fast acting) and we quickly had to switch to .5 unit.. it was that way until a little before she started pumping..

    are the lows they are experiencing coming anywhere, or are they after a meal dose? I'd say that they need to back of that lantus dose.. but idon't know the family nor do I know where the lows are coming in..

    good luck to them!
     
  3. EmmasMom

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    Wow, I didn't think ANYONE used regular anymore. It's completely outdated and it makes no sense to put a baby on it at all. :eek:

    The beauty of fast acting insulin in small children is that you can dose after they eat, this is hardly new info... surely the endo has some, (insane???) reason for using it. Diluting Novalog yourself isn't all that hard, (as long as you follow the directions carefully), and would be much better than giving regular just because it comes diluted.

    I also agree that 3 units of Lantus seems like a lot. Emma was on 1 unit, sometimes 1/2-3/4 unit per day at that age, and she was pretty big for her age.
     
  4. Mama Belle

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    Oh my goodness! R? Seriously? I can't even remember how long ago it was that my dad stopped taking R, but it was a loooong time. Seriously? Wow.

    Aside from the bad choice of R, I wonder the reasoning behind the 3 units of Lantus. That is a huge amount for such a little body.

    Personally I think the regimen stinks and they should find a new endo.
     
  5. Twinklet

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    I also know of no one IRL who still uses R. I thought the only use for R anymore was mixed in an IV bag for hospital use.
     
  6. Jen Jen

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    R is actually still used quite a good bit, I wouldn't say it's a bad insulin at all. Not everyone can use the rapids, people tend to have more severe allergies to them, R is easier on the body. Price may also be another factor, insurance, medicaid, etc... The dosage for the Lantus does seem a bit excessive for a ten month old, that is where my concern would lie, especially if the lows are too frequent. If the parents are comfortable with it, they can adjust their child's dosage. If they're not, that may be another reason why the doc has them on an R/Lantus combo, they may not be ready for more shots yet. They need to learn how to focus on stability, but telling them R is aweful will not help the situation at all. They need positive support and information about what they are using, not opinions.
     
  7. kiwikid

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    When Rachel started on insulin (11 months old) we used Humalog. It was too hard and fast for her, causing big drops, so we changed to Regular and things were more even.
    I ended up using a mix of the two which worked really well until we started pumping. :cwds:
     
  8. CarrieP

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    Thanks for all your input!!

    As far as giving them negative input, I would NEVER do that. I told them that I was surprised to hear they were on R and asked how it was working. I also asked about lows. Otherwise, I told them to talk to the doc about the lows, because I am not a clinician and would never assume I know more than the doc!!! *smile* Well, as far as they know!!! *grins* I also offered my help whenever they need it.

    Thanks again for all the input... I just needed to hear from others what is going on out there. It relieves me to hear that someone actually took R by necessity and that it worked better for them.

    CarrieP
     
  9. sammysmom

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    It is not unusual to start at a higher dose of lantus when first dx. Once the insulin gets into the system and the body starts to recover from the excssive high blood sugars upon dx, that is when you will see the need to start lowering the dose. My son was dx at 15 mo old and was started on 6 units of lantus.......as for using the regular, some people find that the rapid, is just too fast for the body. I think that there is nothing wrong with using what works. If you take a room full of people and question them about diabetes care you will get different opinions. I know a bunch of people that say the pump is no better than injections. That may be true for them. The best thing you could do is just be there to offer support to that family and it sounds like you are already doing that...good job!

    shannon
     
  10. selketine

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    Humalog is a fast acting insulin that can be diluted - our pharmacy ordered the dilutent and did it for us. A "compounding pharmacy" can do it. I've read here that some parent did it themselves after training. We used diluted humalog for William and with the 1/2 unit marked syringes we could give 1/4 unit doses that way. This seems much easier than regular - which really does't get you out of shots....most docs seem to prescribe NPH to cut down on the number of shots. I guess the ? would be to ask why the dr. chose regular instead of diluted humalog? William was on regular in the hospital and our 1st day home - which is when his pedi endo took over and switched him ASAP (and before I really understood what regular was).

    Regular might have its uses for a baby who eats slowly or ? William was always a very consistent eater - but he was 26 months old. A 10 month old is very different of course. I hope they talk to the dr. about it.
     

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