From Ada, Oklahoma, USA:
I have an almost-4-year old son, diagnosed at about age 2. He weighs 35 pounds. One unit of Humalog covers about 35 grams of carbohydrate for him. Two units of Ultralente in the morning and 1 and a half units in the evening keeps his blood sugar in the desired range even if he skips a meal during the day. Overnight is unpredictable. I read somewhere that one gram of carbohydrate raises the blood glucose of a 100 pound person 12 points. I'm wondering what the formula is for a 35 pound child? Also, is there a formula I can use to accurately bring his blood glucose down? One-half a unit of Humalog seems to bring it down about 100 points or more. If his blood sugar stays high for several hours, does it continue to rise? Or is there a stopping point? We, and it seems many others, struggle with the bedtime formula. Is there a specific formula of carbohydrate, protein and fat I can feed him before bed to keep him from going too low or too high?
Your experience is probably the best teacher. There is a "1500 rule" that was developed by Paul C. Davidson, M.D. The total amount of insulin taken for the day divided into 1500 equals the expected drop of blood sugar by one unit of regular insulin. How many units blood glucose drops does depend on weight, age, and sensitivity to regular insulin (younger children seem to be more sensitive to regular insulin). You may want to look into a book called Stop the Rollercoaster: How to Take Charge of Your Blood Sugars in Diabetes by John Walsh, P.A., C.D.E., Ruth Roberts, M.A., and Lois Jovanovic-Peterson, M.D. There are many helpful suggestions in this book
Original posting 8 Mar 1998
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