Insulin change - Lantus vs. Levemir

My daughter Olivia will be 3 years old on Feb. 8th and she was dx on 6/12/07. Our last endo. appt. was last week and our Dr. was concerned about her high numbers between afternoon snack and dinner and was also concerned about her lows during the night, so he decided that changing her insulin would be a good idea. She was pevious on …
Breakfast 6:30am humilin N (NPH) - 3 1/2 units, a sliding scale of Humalog (<150=1/2 unit, 150-250=1 unit, and >250= 1 1/2 unit)
Lunch 11:00am - nothing
Dinner 5:00 pm - same sliding scale of Humalog listed above and 1/2 unit of Lantus.
Bedtime 8:00 - <150=0, and >150 = 1/2 unit Humalog

She had an A1C of 7.6 (1st a 10.2 then previously a 8.2) and a monthly average in the 150s. So overall, we were happy.

She is now on…
Breakfast 6:30 am Novolin N (NPH) - 2 1/2 units, a sliding scale of Novolog (<150=1/2 unit, 150-250=1 unit, and >250= 1 1/2 unit), and 1 unit of Levemir.
Lunch 11:00am - nothing
Dinner 5:00pm - A different sliding scale of Novolog (<150=1 unit, 150-250 = 1 1/2 unit, and >250= 2 units) and also 1/2 unit of Levemir.

It has only been a week on this new insulin, but her numbers are TERRIBLE. They are above 200 and the Dr. and Diabetic Educator have changed her doses to what they are above, but it really hasn’t lowered her numbers. We are faxing her readings to Pittsburgh children’s hospital again and without a doubt I know that they will change her doses again. I FEEL FRUSTRATED!!

I know that everyone is going to say put her on a pump, but she is just not ready for that - she won’t leave a bandaid on for more than 5 minutes and I’m scared to go to the pump when she does that. I need to get her a year or maybe two years older - so she understands better! Am I crazy???

I know inside that I have to give this new insulin a change and I know that We will be changing her doses every three days or less until we find the right combination just like we did when she was dx, but I can’t stop feeling what these high numbers are doing to her body - and it makes me on the edge.

I’m interested to know what everyone else is doing with their children that are dx so young. How many units? Has anyone else switched from Lantus to Levemir? ETC.?

hello,this is the first discussion that I have ever replied to.but I feel that we are a little on the same daughter is 4 and was diagnosed 10/5/07.11 days before her 4th birthday.(what a birthday)and whats ironic is ,we go to pitts. hospital we prob. have the same endos.and docs.I do know what you are going through.becouse we go through the same thing.they have never changed her medicine though.they just keep changing her sliding scale.its either to much insulin or to has helped when they told me to giver her the shot,then wait 10-15 min for her to eat.I have the same fears as you.that every time she goes high or low that it is affecting her body in a bad way in the future.I have been doing as much research as I can on pumps,I would like for her to get one.but I don’t know if her 2 yr old sister would leave it

It sounds like we are on the same page. Thank you for your comment. This is a great site to belong too. I have learned alot. I also am looking forward to the pump, but right now with Olivia being 2 years old I’m afraid that she wouldn’t leave it alone (she will be 3 on 2/8. Is your daughter also on NPH? That insulin is so unpredictable. We are going to see if they can take her off of it and strictly have her on Novolog and Levemir. How often do you contact Pittsburgh? We contact them at least once a week. I have so many questions for you - LOL! Feel free to ask me questions too.

I have ALOT of but what diabetic doesnt ?allison is on lantis and humalog.I don’t know abbreviations very well, so might take me awhile to figure out what your saying to me.I used to call childrens quite a bit,but it takes so long for them to call me back (if at all ) that I end up changing her scale myself.only by 1/2 units though.I have been all over the web finding info. on pumps.I have read good and bad about all of them.we have an appt.march 3rd I am going to ask about wich one they recommend and how soon we can get the ball moving.becouse I hear that its takes quite awhile and alot of red tape to get the insurance companies to cover the there is alot of education appts to go to.i’m definately considering the omni pump,becouse there would be no tubing for her 2 yr old sister to yank bath time when they are pretending to be mermaids.but i’m keeping my mind totally open to all others.tell your daughter happy birthday !!! : )

Hi Rhonda,

I’m sorry you are having trouble getting your daughter’s numbers in range. NPH is awful for little kids. It’s too variable, although some people have good results with it, we never did. My son was 3 when he started to pump (3 years, 3 months old) and it was a godsend! He never played with his pump. I did give him an old beeper that he could pretend with though and this seemed to satisfy him. Every child is different.

Thanks Rhonda! Our next appt. was supposed to be in April, but the appt. book was full. Our Dr. is Dr. Escobar. He is really nice. So it looks like May will be our next appt., but the May calendar is not out yet! I usually e-mail our Diabetic Educator. I used to call/fax and it took so long to get a response too. I’m interested in what you find out about the pump. Talk to you soon.

her dr.sorkken , but normally I call her educator to.(shes great)they are totally understaffed,but she found the time to go to allisons headstart to teach them how to do meter how to do emergency glucose shot.I think the school paid her but not sure.but her name is takes her quite awhile to get back to me .but I remember when we were in the hospital that the docs told us that sadly about 6-12 children get diagnosed at that hospital a week.that is so is she doing ? I can imagine how planning her birthday is going.I went through that 11 days after she was mother inlaw and I kept arguing about weather to have birthday cake or not.of course i said no ,becouse I was afraid she would walk by and “finger” some was too soon after getting out of the hosp.

My daughter is 6, dx just before her 5th birthday a year and a half ago. She has been on the pump since June '07. She has a 1 1/2 yr old brother. He is of course curious about the pump, but really good about not touching it. Plus, the pump has a lock on it that a 2 yr old definitely could not unlock. I completely recommend the pump for numerous reasons, but one mostly: I LOVE that I can check how much insulin is still in her body. Sometimes we do a check and she is running high, I can look in her pump and see if she needs to be corrected or if she still has insulin in her. OR, I do a check and she is starting to go on the low side, I can see if she still has insulin in her body that will make her go lower, that way I know she needs more to eat. THAT REASON ALONE IS WORTH HAVING THE PUMP. You have way more control.

But again, her little brother is really good about not playing with the pump, and also, it’s made out of “football helmet” material, so not much damage can easily be done.

I think we all worry abou the high numbers and what they are doing to their little bodies, you can’t help it. But I was told that there isn’t any evidence that high numbers in kids younger than puberty have any lasting damage. It’s not much but I hang on to that when I worry. Even with the pump we are constantly fiddling with the doesages, as she gets older her insulin needs change so we often have to challenge her carb to insulin ratios as well as BG to insulin doses.

One thing I am curiuos about, are you feeding her the same things for breakfast and lunch and dinner every day? Having different fat and protein in a meal can cause her blood sugars to fluctuate. Not that they need an excuse, but we do try to make sure we have a night time snack with some protein and fat in it so that it lasts through the night and she doesn’t wake up low.

Good luck.


Hello! My son was diagnosed 8/07 at age 19 months. He was put on Lantus at bedtime with sliding scale Novolog for meals at that time, and we are still using this. We dose the Novolog based on his blood sugar and how many carbs he eats. We try to keep his snacks to 10 carbs (which, as you know, is difficult with a toddler!!). He’s never been on NPH, and I don’t know of people who have been on NPH AND Lantus and Novolog, but I know there are many different combos. From what I’ve heard, Lantus and Novolog (or Humalog) is pretty much the way most people are going.
I’d say keep on your endo… keep doing your own research and bring your suggestions to him. You are the mom and your instincts are best. You may want to look into using Lantus once a day (we use 1 1/2 units at bedtime) then covering meals with Novolog. I change my sliding scale ratios on our own all the time (never call the endo office), and add in a correction for sugars out of range. Now Isaac takes 1 unit Novolog for 15 carbs at BF, 1 for 30 at lunch, and 1 for 25 at dinner. If he is consistently over 200 at dinner, I would change his lunch ratio to 1 for 25. I also check his sugars 6-7 times a day.
I don’t know if this were helpful or confusing. But I do know we have had many spurts where sugars seem to run high for a week at a time for no apparent reason, and times when they run low. From what I hear, this is the nature of the game - esp with a toddler. We try to ride with it and look at “the bigger picture”, which at this time is the A1C. Also, try to remember that we’re doing our best, even when our best doesn’t feel good enough for our precious little ones.
With that said, we are in the process of getting a pump for Isaac (Omnipod). We’re hoping that he’ll adjust well, as I hear most little kids do. They’ll just get used to it I think.
Let us know how you’re doing!
Mom to Naomi (5) and Isaac (2… dx 8/07)