u/ImportantBar4006

Hi- I’m an outpatient RD and I have little experience with type 1 DM pediatric population.

I have this one 13 yo pt who is taking pre-meal insulin based on a sliding scale. Is this common??? He has a dexcom and his BG ranges are usually >200 m/dL after meals, 180’s fasting. Based on the prescribed sliding scale, is taking:

3 units for BG 70-100 6 units for 101-200 9 units 201-300 + With 21 units of lantus at bedtime.

His a1c is 9.4 as of March

I thought that insulin should cover meals, not cover based on pre meal BG readings.

If he has take 9 units before a meal based on a high BG reading, 135gm Cho seems excessive for 1 meal??

Please, point me to any resources that can help me out. Thank you!