# Feeling lost-



## prayn4cure (Jun 13, 2012)

I am a parent of a newly diagnosed 6 year old Type 1. She used to have about 20 carbs before going to bed and taking 2unit of NPH (humlin)to wake up between 6 and 6.5. but recently she wants to eat more at bedtime. (about 40 carbs) what should I do? give her fast acting to compensate for the extra carb? We have dinner at 4 so by 8 she gets pretty hunger, and she is an active girl. your advice is appreciated


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## Northerner (Jun 13, 2012)

Hi prayn4cure, welcome to the forum  Very sorry to hear about your little one's diagnosis. Have you been taught to carb count? I see you are from Canada, so what is available there may be very different from here, as we are primarily a UK forum. What insulins is she on exactly, as Humulin can come in various guises (Humulin R, I, N, 70.30 etc.) What is the 'fast-acting' you refer to? The ideal insulin regime would be basal/bolus i.e. a slow-acting insulin (basal) once or twice a day, plus a fast-acting insulin (bolus) to be matched to the amount of carbs consumed in meals. Using this system you would increase the fast-acting insulin to account for the extra carbs using a carbs to insulin ratio appropriate to her at the particular time of the meal (ratios can be different at different times of the day. If you are not sure of her ratios, then your should discuss this with her specialist diabetes nurse).

You may be able to find more help at http://forums.childrenwithdiabetes.com/


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## HOBIE (Jun 13, 2012)

Good luck with this !  If it where me i would have things before bed when still active. I know there is no perfect answer, but try low carb things like ommelettes,fish.  Six yr olds can be fussy at what they eat.  Hope things go well


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## trophywench (Jun 14, 2012)

Same insulins as here available in Canada Northie.

Girl on t'other forum was on either Novalog or Humalog and Lantus, but changed a while ago to Levemir.

Because of the mixed profile of NPH which has an alarming peak and lasts ages but not 24 hours, the 20g snack at bedtime would probably be given to feed the insulin and prevent the patient going hypo in their sleep.  The usual regime here was Humulin I as basal and Humulin S as  bolus.

Nightmare insulin to try and titrate properly at home .... whilst trying to have a normal life - was regularly high or hypo.  I got off both of them as soon as I could - years ago.

So my guess would be Yes, you would have to add fast-acting if the child MUST have carbs - but I think HOBIE has the best idea - don't give more carbs, if she's hungry try giving her extra protein instead.


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## Ruth Goode (Jun 19, 2012)

I let Carly eat more when she is hungry,  sadly that mean more insulin but she is happy to have it to eat more


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## ageez (Jun 19, 2012)

Hi, there. Would she accept a couple of little sausages, some cheese, something like that? My six year old has a few little Ritz crackers and a drink of water or sugar free fruit squash for snacks and this doesn't tend to require any insulin. We find that snacks that contain less than 10g carbs do not raise his blood sugar very much. Could you move her dinner a bit later? My son has a snack when he gets home from school and then dinner at six, so he isn't usually hungry at bedtime.

I really feel for you. My son was diagnosed about 18 months ago and it was such a horrible shock. It still is, actually!


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