At first, your diabetes team will decide how much insulin your child gets (the dosage) and how often he gets it (the frequency).
This is the insulin regimen. It can take a few days to a few weeks of fine-tuning to figure out exactly how much insulin is
needed. In general, it is not possible to achieve and maintain excellent blood sugar control with just 1 or 2 injections of
intermediate-acting insulin alone. Eventually, most children and teens need both fast-acting and intermediate-acting insulins
3 or 4 times a day, or they may need or choose to use a pump.
Generally, the following schedules are followed at the start of insulin therapy:
-
Infants, toddlers, and preschoolers receive 2 injections a day. They are a mix of fast-acting and intermediate-acting insulins
before breakfast and again before supper.
-
Older children (5 or 6 years of age or older) and teens usually start on 3 injections a day. They would use a mix of fast-acting
and intermediate-acting insulin before breakfast, and fast-acting insulin before supper. At bedtime, they would take intermediate-acting
insulin. Some centres prescribe insulin twice daily to start, combining the fast-acting and intermediate-acting at suppertime.
-
Some older teens prefer to move to, or even start on, a 4-injection-a-day routine. They would take a
dose of fast-acting insulin
before breakfast, lunch, and supper. At bedtime they would take an intermediate-acting insulin. Some also choose to take fact-acting
insulin before major snacks to avoid high sugars afterwards.
Since a child’s insulin needs are affected by her growth and development, appetite, physical activity, and stress or illness,
no fixed dose will work forever. The dose must be adjusted to provide the best blood glucose control.
Over time, blood glucose levels become stable and families gain more experience. Most parents and teens become quite skilled
at taking charge and making decisions about changing the insulin doses. The diabetes team is always there for advice and backup.
