As our children with diabetes grow, their insulin needs change. When you are used to making tiny changes to doses, the first time you must make a big change in your child’s insulin dose can be terrifying!
My son was first diagnosed with type 1 diabetes when he was 2 years old. Insulin corrections were made in tiny increments. The first time we made an insulin adjustment that made me give him a full unit more of insulin, I was scared to death. My child seemed to use a lot of insulin!
But that is relative. I had to remember that if he had a functioning pancreas, I wouldn’t be seeing the amount of insulin his young body was using. I wouldn’t see his basal rate or know what carb to insulin ratio his pancreas was using at breakfast or supper.
Twenty-nine units of insulin for breakfast
I remember one morning when my son had sat down to eat a huge stack of pancakes. He was a teenager with a big appetite. Because he was a teen, he also had a lot of hormones racing through his body creating some insulin resistance. His morning carb to insulin ratio was one unit of insulin for every 5 grams of carbohydrates. 100 grams of carbohydrates in the form of pancakes plus his toppings equated to 29 units of insulin.
“Twenty-nine units! Wow! That’s a lot of insulin.” He exclaimed.
I responded that “it’s what your body needs for what you ate. If you are worried that it’s too much, you will find out when you check in a few hours.”
A few hours later, his readings were in range. His body really did need all of that insulin to deal with his carb-laden breakfast.
The insulin needs of a child with diabetes change over time
When my son was a toddler, he wouldn’t use 29 units of insulin in a day. When he began pumping at 5 years old, I would only fill his insulin pump up to 150 units. I would still have to throw out insulin after a week.
I remember when my son’s basal rates changed from .1 unit per hour to .5 and then 1.0 units. It was terrifying. I had to keep reminding myself that this was what his body needed.
As children grow, their appetites change. Their activity levels are also different. This means that their need for insulin also will change. It doesn’t mean that their diabetes is getting better or worse. It is simply a part of the changes that life brings.
As they grow, and as they settle into life with type 1 diabetes, it is important to always remember that there is no one-size-fits-all insulin routine. The type of insulin used, the method of insulin delivery, and the schedule of injections are all individual. You must constantly work with your diabetes team to make adjustments as your child grows.
Hormones will happen. Illnesses will create havoc. Routines and schedules will become disrupted. Watch for patterns. Reach out for help. Use the best tools available to you and make them work.
When my son was a child, we started out on NPH insulin, Humalog, and a glucometer. With careful monitoring and measuring, we were able to maintain tight control throughout his childhood and teen years. It is hard work.
You are not a pancreas
Living with diabetes isn’t easy. It is important to remember that you are doing the work of a human pancreas. That is no small feat. A pancreas has much more knowledge of what is going on inside a human body than you do. You can only do your best.
Your best may include having to dose what seems like a lot of insulin for your child. That is okay. With careful monitoring, you may find that a lot of insulin is just what he or she needs!
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