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Message: <blockquote data-quote="phoenix" data-source="post: 230992" data-attributes="member: 12578">Just in case there's any confusion in terms (and hope not to confuse more) The parents have far better advice than I on the pratical day to day use of insulin in children  In my earlier post I picked up on your sliding scale phase. My understanding of this phrase  actually differed from  Sophies. I ttook it to mean that bolus(fast acting)  insulin is dosed in response to the glucose reading , and not the amount of carbs to be eaten.  It's a method  often used in hospitals using a drip. (and often keeps glucose unnecessarily high) There are some people who  are start insulin using  an adaptation of this method. It uses rapid insulins for meals and a basal for background. You test, and inject ,the amount dosed  may be altered  by  a unit or 2 if the level is above or below target.  It is reactive  and  it can only be  effective with a fairly rigid diet and exercise plan. (and children don't live rigid lives) The more  recent , more flexible method  used by many of us today,  is to use a basal insulin for the background  and inject a bolus that takes into account things like the  present glucose level , prior or subsequent planned exercise and  crucially the number of carbs to be eaten. A third method is a mixed insulin regime  where both basal and bolus are alreasy  combined  (premix insilun) within one injection,( given 2 or 3 times a day) This is as Sophie describes, less flexible as if the dose is increased to cover more carbs, the basal (background) element is also increased</blockquote>

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