Novolog over Lantus dose?


(4Knicko) #1

My 7 y/o son was dx almost a year ago and this is our first winter season that he has type 1 diabetes. It has been a struggle to maintain his bs levels specially at times when he catches a cold. It seem like his insulin doesn't even work (novolog and lantus). It is depressing at times but my question to mothers out there with kids taking the same insulin is that , do you try to give the same amounts of novolog & lantus per day or do you oftentimes exceed the novolog dose over lantus dose? Will that affect his A1C levels?


(Lisa kasabian) #2

My son is 10 years old and has been a diabetic for 8 years.  He is  using Humalog and NPH but I belive the situation is the same.  Whenever he becomes ill it raises sugar levels because the body is trying to fight off the virus or infection.  When this happens we have to test more often (1-2 hours) and we do increase insulin if needed. 

Sometimes with the flu we will decrease the insulin if for example he is not eating.  For example, we have cut the slow acting insulin in half and then given small doses of fast acting insulin to cover any increase in sugar over the day.

Hope this helps. 

 


(IndyDon) #3

If you don't mind a dad replying....My son is on Novolog and Levimir (very similar to Lantus, just made by a different company).  When my son is sick it often, but certainly not always, requires higher doses of Novolog.  If he is sick and not taking antiobiotics then it might be a slight bump of the Novolog.  If he is taking antibiotics (like right now) then his Novolog dosing can almost double.   Then when he comes off the antibiotic he sometimes needs less Novolog than usual.  My son just had strep throat and his final dose of antibiotics (5-day regimen) was today.  The first day he took the antibiotic he needed a lof of Novolog and he did not eat many carbs at all.  Then each subsequent day we were able to cut back on the Novolog until the 5th day of the treatment he was back to normal Novolog levels.  This time we bumped the Levimir dose on the first day but then dialed back to his normal routine.  In general, I prefer to change the Novolog dose rather than the Lantus/Levimir dose.  Sick days are a real pain because blood sugars can be all over the place, you can have issues with ketones, and you need to adjust the insulin dosing a lot. 

The A1C essentially represents an average blood sugar reading over several weeks.  Elevated blood sugar levels will influence the A1C but the extent will depend on how high the blood sugars are and when they occurred.  The A1C test is harder to explain than the quick answer that is often provided.  More recent blood sugar levels represent a higher proportion of the overall A1C total than older levels.  I would not worry about the A1C test itself.  Just focus on the blood sugar readings on a day to day basis and the A1C should be within the range that your doctor recommends. 


(Daniels Mom) #4

We are so new to this also (June 30 of last year).  I am intrigued by your question particularly the "do you oftentimes exceed the novolog dose over lantus dose?"

It has never been suggested to me that they were related to each others' dosages.  Much less that they should be the same.  Do you mean; if you give 6 units of novolog in the evening that you also give 6 units of lantus??

I look at them completely separately.  Did I miss something?


(4Knicko) #5

Hi Don, thanks for that reply specially the A1C part. I really should talk to the endo more about about it.


(4Knicko) #6

Well, my sons' lantus dose is 6.5 units and I normally give the same amount of fast acting novolog for the "entire day".  His endo explained that it is essential that both basal and fast acting insulin be the same amounts in order for his body to maintain balance and not disrupt other hormones that could eventually affect his growth e.g. hypothyroidism and hyperthyroidism.  Since I have been trying to maintain balance, His height and weight was well proportioned  to his age.

This insulin (lantus and novolog) also act as growth hormones our body need for proper growth and development and not just to control blood glucose. But in case of sickness, his bs goes crazy high which prompts me to give 1-2 units more of novolog all through out the day depending on his carb intake, but of course you should always discuss this issue with your endo. Hope this helps.

 


(Lisa kasabian) #7

The information on insulin controlling growth hormones and hypo/hyper-thyroidism is interesting.  We go to our endocrinologist quarterly at Children’s Memorial in Chicago and they have never mentioned this.  Now we have been on Humolog and NPH for all 8 years so it's possible that lantus and novolog affect hormones differently.  I will definitely ask next month as we were told that we would go to lantus before going on the pump so one day we may switch.

Yes we always adjust insulin based on blood test results and for us, there is no tie between the dosage for Humolog and NPH.


(Kaprice) #8

Hi

My 6 year old was diagnosed in Dec, 2008 so we are new to this.  My son is also on Novolog and Lantus but we use it differently than you have been prescribed.  My son get 7 units of lantus in the morning and his novolog is given after every meal depending on the amount of carbs he has eaten.  Do you carb count or are you on a strict diet with the same amount of carbs for each meal?

I also have never heard of novolog being used as a growth hormone.  My doctors are out of Lutheran General Hospital in the Chicagoland area.  I may ask that question at his next visit.

The discussion regarding colds is very helpful to me because my son currently has a cold and this is his first since diagnoses and his night time levels seem to be sky high when they are usually nearing 100.  It eases my mind that this happens during colds.  Thanks for all the advice you all shared. 


(Reillysmom) #9

I was intrigued by the same thing!  For us there is no correlation between the lantus and the novalog!  (At least I don't think there is)?  Now I have something else to worry about! 


(Daniels Mom) #10

Dear Reillysmom

Yep, it is now on my list of items for the next appointment with his dr.  We speak with her a couple of times a week; but not about stuff like that.

I'm with you.  Something else to worry about.  Currently our challenge is this:  6 units of novolog at breakfast gets his "before lunch" blood sugar at 250-300 but 6.5 units takes it to between 37-60!  Gotta love that.

Since there is no such thing as a 1/4 unit; we are now talking about something she referred to as diluted insulin.  Sounds FUN!  Bet there is more "math" involved.   :) 


(ShannonSamples) #11

My son Christopher always ends up dealing with higher bgs when he is sick. As a matter of fact, I had to get a sub today because he got up at 5 am with a sore throat and body aches.  We've been checking for ketones also. It is so hard to distinguish between the colors for negative and trace!  He has an appointment this afternoon to see what ailment he has. We have had so many students with flu and with strep. I didn't want to take a chance with waiting to see if he would feel better. The last time he had strep was about a month before he had his tonsils out. His blood sugar was crazy. We had to give extra Novolog at each meal for about four days. He is also on 11 units of Lantus at supper. We didn't adjust that dose.


(Reillysmom) #12

I am Feeling really lucky!

Reilly gets 5 units of Lantis at night and 1/2 a unit for every 10 carbs at home...we do 1/2 unit for every 12 carbs at school.  She isn't much of a breakfast eater so she will usually have an egg or cheese, something she doesn't need a dose for and then she has a small juice at about 9:30 which keeps her going to lunch.  (She usually wakes at 110-125 and is usually about 120 at lunch)

I obcess over these numbers.  She was running high averaging at about 180 over a 2 week period and I was told by my educator that the "honeymoon" is most likely over.  We doubled our lantis and incresed our Novalog by 50% and all seems OK at her current dose.  At least has been for the last week!  We all know how that goes!  Everyday comes with a new challenge!

 

 


(Daniels Mom) #13

We are on a "set carb" meal plan.  60 grams at Bkfst; 30 gram snack; 60 grams Lunch; 15 gram snack; 75 gram dinner; and 15 gram bedtime.  My little dude loves to eat.

We religiously take his bloodsugar reads before breakfast, lunch, dinner, bedtime, and sometimes 2 a.m.  These reads tell us how the insulin worked on the previous meal/snack.  However, we have (of course) checked in between these numbers for various reasons and find that just about the time they are "in range" it's time for another snack or meal.

He eats.  It goes up.  It just gets back down and it's time to eat again.  Really, how much time are we spending "in range".  I don't completely understand yet.

By the way, my friends are all thanking you (members of this site).  Now instead of talking to them about diabetes ALL THE TIME, I can discuss it here and get at least some of it out of my system.  THANK YOU!


(cschultz) #14

Our Dr. found by doing a pump study that Novalog lets the pump sites last longer.  We have had better results with our pump sites since we switched to Novalog.  i have had a couple of friends change to Novalog and have told me that thier childres sites lasted longer.