Increase in insulin unit, after what duration?

i want to ask for growing children roughly after how many months , there is need for more units, my daughter aging six years old , is on same units 6 months ago , her hba1c is 8 (recent)

Everyone is different & there’s no formula or set answer. Not a good A1c–sorry for her high BG.

She needs one or more of the following:
An increase in dose
Better timing of insulin
More accurate insulin:carb ratio
Better carb control or carb counting

Since her A1c is recent, did her doctor suggest any changes?

Bad and good are really not appropriate words to use in terms of BGs and A1Cs. Remember that they are merely one method of evaluating our control. You certainly can’t make minute changes based solely on a massively large-scale measure of an A1C.
Also, the idea that the lower the better for an A1C is a bit of a scary idea - especially with kids. Expectations for children are a little more lenient.

With that said, there is probably some room for evaluation of your daughter’s current regimen. Look for trends. Generally, the bigger the body, the more insulin it takes, BUT that’s not a causal relationship. I would probably start by checking her overnight sugars for trends.

Remember, just the fact that she’s growing isn’t reason enough to make specific changes. With the info you’ve provided, it’s impossible to tell whether this is a long-acting or short-acting insulin problem, or both.

I have lots of questions for you - and they’re not really for me. They’re to bring up areas for discussion about this with your doctor. There’s a lot of information needed - and I believe if you have an A1c, you’ve got an internist or endocrinologist within traveling distance. -
Take two week’s worth of test results - at least 4 times a day pre-meals and bedtime, and preferably 2days with tests one hour and two hours after breakfast and lunch, 2 days with tests one hour and two hours after dinner. For everyday, record the times of tests, the times of starting to eat, the grams of carbohydrate with the name of the food. For each time you give her insulin, record the time, type of insulin, and dose. Now look at it all, figure out what patterns you see, and talk it all over with an endocrinologist.
We’d all like to see a lower A1c in your daughter. And we share your frustrations. We know you’re trying to prevent complications. Today endos are trying to keep blood sugars below 140mg/do or 7.8 mmol/L. But you can’t do this in children without professional help.

I must agree with Leona… Did you catch what she said there at the end… “Today endos are trying to keep blood sugars below 140mg/do or 7.8 mmol/L. But you can’t do this in children without professional help.” Children are extremely difficult to regulate…

Specific trends are the key. If you aren’t seeing high numbers in Bg during the day to account for the elevated a1c, then it’s probably happening overnight. Try keeping tight records as mentioned earlier by Leona and see what picture unfolds… Sometimes it will surprise you, but don’t take one day as an example… It’s the picture painted over time (be it a week or two, or a month or two) that you should react to…

Good luck!


Her insulin needs will vary throughout her lifetime. If you haven’t met with a diabetes educator to go over her numbers with a fine-toothed comb, I highly suggest it. My insulin needs rose steadily throughout my life, falling only after I either switched therapies (from shots to pump) at age 20 or changed my diet (Weight Watchers) at age 28. Don’t stress too badly if she needs more insulin with each phase of growth. Just work with your medical team to determine how much and when. Hormonal changes, puberty, stress, growth, illness, etc…there are so many factors in a child’s life that cause a change in insulin needs.