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  1. Harold - David's Dad

    Harold - David's Dad Approved members

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    Our son will be starting on Lantis this week (currently he does injections at breakfast, dinner and bedtime) because he wants to have more flexibility with his eating/sleeping. We are just getting all of the information together but some quick questions:

    1. is it recommeded to try and eat about the same number of carbs as he is currently doing to maintain some regularity?
    2. do you still have to have a snack in the morning, afternoon and at bedtime

    Any other advice or problems with the switch over.
     
  2. Amy C.

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    When my son switched from NPH/Humalog to Lantus/Humalog, he started out with 3 snacks a day. Very quickly, I realized he needed only the afternoon snack.

    Each child is different and you will need to determine what the pattern for your son is.

    Is he counting carbohydrates and giving the short acting insulin based on the carbs eaten and sugar reading before the meal? If so, he can eat whatever he would like. It is easier if the meal is consumed at once, rather than spreading it out over time. It is hard to be a grazer on shots.
     
  3. Boo

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    What is his current insulin regimen? Is he on NPH now?

    I'll assume with a switch to lantus that he will be carb counting. Once you get accurate insulin to carb ratios, he should never HAVE to have a snack (unless he is low, of course). With carb counting, he will not need to eat the same number of carbs at each meal every day. You will have much more flexibility. However, the more accurate your carb count, the better control you will have.

    You may find that your son's insulin/carb ratios change throughout the day. For example, my son used 1 unit for every 15 carbs at breakfast and lunch, but used 1:20 for dinner and any bedtime snack. This is just something that your endo can work with you over time to figure out, depending on when he is most sensitive to the insulin.
     
  4. cydnimom

    cydnimom Approved members

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    We went from using NPH to Lantus last August. We started with one shot at bedtime, but found that his blood sugar was rising shortly after taking the shot, which indicated that it was not quite making the 24 hour mark and would start to wear off before the next needle was kicking in. We ended up splitting the shot - breakfast and supper. Its almost a 50/50 split, with a little more at supper.

    We have found that the only snack he really needs is a small snack in the afternoon - about 15 carbs. He only has to eat a snack in the morning if he has gym and its only around 10 carbs for the 1/2 hour.

    Basically if he wants to eat he takes a needle. It would really be nice if you could mix the Lantus with the rapid (then we could mix breakfast and supper and reduce the shots by 2) - knowing fully that it will work like its supposed to. If they come out with a full fledged study indicating that there is no difference then I would mix, but I haven't seen anything legit so far. Anyone else seen any study done on this?
     
  5. D-Dad

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    Once you start carb counting you can start figuring out how much insulin you need to "cover" carbs eaten and only eat when you want to. Eating the same thing for a few days is helpful when determining these ratio's and learning how different foods effect the BG. If you’re going MDI - you may want to check out a pen - it's easier and hurts less. However, if you use the pen, count to 10 after injection and before removal - to ensure that the insulin is absorbed.
     
  6. Big Hair Momma

    Big Hair Momma Approved members

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    There was recently a study done at the Barbara Davis Center that determined in most children mixing the two insulins produces the same result as giving them separately. We have been mixing our Lantus and Humalog since dx'd in Dec and have not had any noticeable difference.
     
  7. sammysmom

    sammysmom Approved members

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    We mixed lantus/log for 4 yrs...really cut down on the number of shots!! Never had a problem with bg control (well at least no control problems associated with mixing the two)!!!

    shannon
     
  8. Mom2rh

    Mom2rh Approved members

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    When Ryan was on lantus, he initially was started on set carbs. I don't know why. He is a growing boy and that was very frustrating. We quickly switched to 15 grams / unit of novolog. That gave him a lot more flexibility. We found though that he did need to snack mid morning and mid afternoon...about 15 grams each.
     
  9. Twinklet

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    My daughter started out on Lantus/Novolog and carb counting. She's never had a set schedule (except giving the Lantus at the same time each night) and was told she could eat whatever she wanted, whenever she wanted as long as we covered it with a Novolog shot. It worked well for us, but each Endo is different.
     
  10. miss_behave

    miss_behave Approved members

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    When I was on Lantus, I ate whatever I wanted, and just injected fast acting insulin to cover it. I soon got sick of injections every time I ate, so I switched to the pump.
     
    Last edited: Jun 6, 2007
  11. Illinifan

    Illinifan Approved members

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    The switch to Lantus radically changed our lives for the better.

    My answers to your questions:

    1. Ultimately, no. One of the beautiful thing about this regiment is that your kid can he however much he feels like at any particular meal and then dose his Novolog accordingly. Like D-Dad said, if you have certain meals you already know the carb count for, then it makes it a little easier to start, but don't sacrifice the freedom you'll gain by unnecessarily limiting his food choices.

    2. No. No REQUIRED snacks, but he can have one if he wants one.

    The key is to keep good records as you start and let your endo know if he is consistently running high or low. Figuring out the insulin to carb ratios for each meal and the correction factor for when he is high is key. These will change from time to time, especially when they hit growth spurts.
     
  12. Harold - David's Dad

    Harold - David's Dad Approved members

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    Thanks for all of the info folks
     
  13. Harold - David's Dad

    Harold - David's Dad Approved members

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    Update

    Well he is now on Lantis and has been for a little over a week. Numbers are still very high at night but he really likes the flexibility.

    Meets this week with the D advisor to review initial results but seems positive.

    Thanks for all of the advice and feedback
     
  14. jeep_bluetj

    jeep_bluetj Approved members

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    Does his nighttime numbers climb? That's a darn good indicator of low basal dose (not enough Lantus)

    i.e. if Bedtime is 120, and Waking is 220, you don't have enough basal insulin overnight. (if it's a trend -- not just one time)

    Commonly, people give 3 days between basal dose changes to really see the results. Your D advisor likely has more info about why.
     

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