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Re: [IP] Sliding Scale Insulin Dose




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>
>Once again I am writing for advice.  My daughters Endo and our Pediatrician
>both say they do not believe in doing "sliding scale" for insulin dosages.
>They say we are just trading highs for lows and it is NEVER recommended for
>pediatric treatment of Type 1 Diabetes.   They say what is below the peaks
is
>what counts and not the occasional peaks.   Whatever her readings are they
>want me to give the same amount of insulin each day.  (this makes no sense
to
>me - why would you give the same amount of insulin for a 300 reading as you
>would for a 90?)


    It does not make any sense. Even if your daughter did EXACTLY the samr
things day after day and took the same amounts of insulin, and eat exactly
the same food in the same amounts, it wouldn't work. I am living proof of
that. I did just what you describe for years and was totally out of control!
I can see taking 20 NPH at a meal and regular on a sliding scale but why in
the world you give anybody the same amount of insulin for a BG of 90 and say
225??? Is this an endo or vet? Below is the scale my doc gave me to follow
and it worked very well.

    Regular Insulin Sliding Scale
Blood Sugar
  0  -  200    give      0 insulin
 201 -  250    give    2 units
 251 -  300    give    4 units
 301 -  350    give    6 units
 351 -  400    give    8 units
 401 -  450    give  10 units

    This was using just plain Jane regular.

>Also, as a mother I struggle with not giving her Humalog to bring down an
>occasional high.  This doesn't happen frequently but on occasion it does.
I
>realize if this are happens frequently and we see a trend it is time to
change
>the insulin dosage.   To not treat the high bothers me greatly.  When I
give
>the extra Humalog I am careful to not do it in conjunction with the NPH
peak
>(so far I have never sent her crashing).   Currently she is on a 2 shot/day
>regimin - before breakfast and dinner.

    In my humble opinion, the closer you can keep her Bg to normal, however
you accomplish it, is all in her favor. You would surely have to expierment
to see what works best, this is exactly why they call it practicing
medicine. These so called MD's that are giving directions like you describe
and have never felt the effects of a 350 or 400 BG, or the low down feeling
after a "crash" have no idea what they are telling you to do!!! I'll tell
them to their face too! Chapps my butt!! Pardon my French. This is part of
the punishment of diabetes. You  wouldn't punish if you knew she was not
guilty of anything?

>If we have the technology available to bring quickly bring down highs then
why
>not?  I don't want to be going against our doctors but I am sense there may
be
>two schools of thought on this.   Any input will be greatly welcome.  Also
if
>I am completely off base please set me straight!
>
>Sherri Lynn (Laura's mom)

    We have the knowledge and it is you place to decide to use it or not.
This technology is what brought on the pump. If you are stuck with a doctor
that is still using 30 year old tecniques you need to come into the 21st.
Century and fire that sucker if that is what you decide. Your move.

Good luck,

Buddy '-) email @ redacted
>


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