Anonymous Question Omitting lunch time insulin?

[Anonymous Question]

Anonymous question submitted:

i am a student nurse, i looked after a child who is a known diabetic, he skipped breakfast then he had a hypo episode mid morning was offered toast and a drink the his bm went to 5.2mmmols, he was advised to omitted his lunchtime insulin, why? is there a rationale behind this decision

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[mo1905]

Only thing I can think of is if you experience a hypo, there is an increased risk of experiencing another within a 24hr period. This is because prior to going hypo, the child will have released stored glucose automatically to try to deal with it. Because of this, it will re-stock it's store of glucose from following meals.

 

[noblehead]

Well if the young fella hypo'd mid morning and his bg returned to normal without a further drop then I don't see why he wouldn't take insulin with his lunch (i'm guessing here he is on basal/bolus and not twice daily injections), If he doesn't take on board insulin with his lunch then his bg will be high, I know some HCP's do advice against giving correction doses at the next meal but never been told to omit insulin altogether.

However, I'm only coming at this from someone who is type 1 themselves so if his diabetes team told you this then better to go along with what they say.