I can't remember who it was, but someone responded to one of my posts saying their daughter/son needs several shot per day, but doesn't need one before lunch at school. What kind of insulin would prevent a shot at school? I would love to avoid it if I can, I can't leave work ever day to give him a shot before lunch everyday and it would also be tough for my husband to leave work at that time. And in the beginning, I am going to be really paranoid about anyone else giving him a shot, let alone sending him to school and me being a nervous wreck.
NPH Insulin can have a peak at about lunchtime. If you use NPH as a "long" acting inslin, you "might" not need a shot before lunch. NPH doesn't last much longer than 12 hours but can hang around for 16 in some people. it can sometimes have a peculiar peak, where it comes on strong and then fades away. NPH can sometimes peak early, like 10 AM which will leave you in a world of hurt if you don't have carbs handy. ... and finally NPH may not peak at all around 12, making you go sky high if you skip a lunch bolus. I took NPH for over 20 years and would not go back on it unless I was forced to. for me, it's too unpredictable and it made me a slave to eating lunch whenever it decided to peak, not when I was hungry. as far as injection paranoia, imagine "it might peak it might not peak" paranoia. good luck.
I'm wondering if the person who didn't need a lunch shot was still honeymooning?
I know this isn't what you're hoping to hear, but I think he'll eventually (if not sooner) need a shot at school. So, I'd start thinking about what would make you feel more confident about it. The d-Moms probably have advice, but I'd think checking in with the school each day at lunch at first might help you feel better?
He does need a shot at school before lunch, but I was wondering if there was any type of insulin that would help us avoid it, lol. I plan on asking his endo. about a pen, it will make it much easier at school.
Through much of my childhood I did an NPH and short acting shot in the morning and before dinner. Your control isn't as good as with the multiple shots, and you HAVE to eat about the same time and same amount each day. But it's another option to the intensified insulin therapy that most people do now.
Yeah, I avoided lunch shots for a few years on NPH too in the 80's, but nph was unpredictable, so I had a lots of crazy lows (and highs). I guess it depends on your priorities...
I know a few parents who have their children on NPH to avoid shots during school. I think fewer and fewer are going that route because as others have said, it can be unpredictable. I think the pen is the safest route - it is most easy to dial in the right dose. BUT you should know that our endo clinic discourages pen use if the dose is less than 2 units because it isn't as accurate. We tried the pen anyway and definitely found this to be the case - our son rarely needed more than 2 units for a meal bolus. (He still doesn't) and so the pen was not a good option for us. I would definitely ask your endo about this accuracy issue before using the pen and I would also make sure I was very comfortable with the pen before I sent my child to school with it. We mostly seemed to find that he would be high after giving him a bolus with the pen but not if we gave the same bolus with a syringe.
A couple options are to train 2 people at the school on how to draw up the syringe or to calculate what he will eat for lunch and draw up the insulin in the syringe for that food. Of course, then he needs to eat what you say (no deviations) and it if he is low or high before lunch, it may be harder for the school to adjust. When my son was in daycare right after dx, I chose to train our provider how to draw up the shot. He mostly ate the same lunch every day, and we chose to have her give the shot after eating to make sure he ate it all. After a few days, she said she was comfortable with doing it. I just went to her house for a few days at lunch to watch her do it so that I would be comfortable.
Good luck. It is nerve-wracking at first but if you get comfortable with the people doing it, it is not so bad.
For about 8 years I never took a shot before lunch, only breakfast and dinner while using Humulin N & R. Even when they added in the lunch hour shot, it didn't help.
The N was my long acting and the R was my short-acting, meal insulin. I only took it at breakfast and dinner...but it was REALLY hard to control my blood sugar levels. We could never get a dose that would last all day and keep my levels in check. I have a hard time as it is without being able to figure out a pattern with my doctor still, but it was even harder then. I don't believe people who carb-count use R anymore.
My endo was shocked that I was still on it actually and said he doesn't prescribe it to patients anymore. He switched me to Lantus and Novorapid 4-ish years ago and I saw an improvement over my levels with N & R. I would be surprised if your endo decided to put your child on it, just to avoid the lunch shot.
I remember those days with NPH. What a mess that was. I think Joe said it best with the peaking paranoia.
I used pens all throughout school until getting a pump and I've been told that "priming" the needle on the pen with a couple of units kind of eliminates the inaccuracy of the smaller dosages but I don't know how true that is. That being said I currently work with a girl with Down's syndrome who is diabetic and what we've done with her is she uses the pens but the school also has a set of cards which state her sliding scale insulin dosages. So 150-200 she gets say 6 units and then has her lunch. Additionally the school called us everyday at lunch in the beginning to let us know. Now they just write it down unless there is a problem then they call. I'm not sure how clear this is so if you have questions just let me know.