Does the 500 rule work for your child?

does the 500 rule of I:C work for your child. 8 months on and we still are struggling. Weve switch from levemir to protaphane back to levemire now on Lantus. The rates change as he grows and eats differently and now is running around. He has between 10 and 12 units insulin max. a day. The endos say not to worry much about carb counting just yet but how are you meant to begin on a pump if I dont learn these things! Others with toddlers help!
Talk me down please :slight_smile:

My daughter is six, almost seven but just diagnosed this last October. So…I’m still learning and a move to pumping isn’t too far off for us either. We’ve only carb counted and adjusted insulin based on bg trends. We use Humalog & NPH with breakfast, nothing at lunch (NPH peaks) and then Humalog and Levemir at dinner. I just plugged our latest TDD insulin number (for 3 days) into what I found the equation to be for the 500 rule (new to me) and found that it said my duaghter would have 39carbs/meal. We’ve actually been steadily giving her 35-37 carb breakfasts/lunch/dinner and 3 15carb snacks per day and our bg’s have been great! Finally. I think if we were doing 39gC at each meal that might be just a little too much. I just hope our bg readings stay this way for at least a few more days. :slight_smile:

Yes, get a scale if you don’t have one. I have one and use it all day, every day - it’s so helpful! Also, there is no harm in learning to carb count. I’m actually finding that I am slowly starting to be pretty good at guessing the carbs on a few things.

The 500 rule has never worked for her, nor the 1800 Rule. Children are much more sensitive to insulin than adults. Never had a toddler with D but you are going to have to ask your endo to help you out regarding this. Applying these rules could be dangerous. Pedi Endo can figure it out. Then you can adjust upwards and downwards from there. Also ask endo how many increments up and down as a general rule when you do adjust. P.S. She had used Lantus and Novolog, now pumping with Apidra.

I have never heard of the 500 rule. Sorry I can’t really give my opinion on it.

I can tell you how we manage. My daughter was diagnosed at 18 months old and is now turning 3 next month. We use what I call a sliding scale approach based on how many carbs she eats and what her blood glucose reading is before she eats. For breakfast she gets 1/2 unit Novolog per 15 carbs, at lunch and linner she gets 1/2 unit per 25 carbs. She does not snack during the day unless she might want some cheese or cold veggies - so no or very little carbs in that. At night time she gets a snack before bed which varies from 6 carbs up to 15. It just depends on her numbers. We also give an extra 1/2 unit of Novolog for every 100 over 200 blood glucose reading and if her reading is under 100 we have 1/2 a unit away. So for a 30 carb breakfast with a blood glucose reading of 270 she gets 1.5 in insulin. Hopefully that makes sense. She is also receiving Lantus at noon everyday and takes 3.5 units of that.

Gosh typing it out seems difficult but with the exception of learning to count carbs and do a little math it is really easy to do. As far as rates changing - yes they change a lot around our house. Sometimes we are increasing insulin other times we are decreasing. We are hoping to pump soon, but until then we just keep tweaking. Good Luck!
Ellen