Transition plan for the child Harshith:

Weight 9.3 kg

1. Diet as per the dietitian

2. To check GRBS pre-breakfast (7.30 am), pre-snack (10.30 am), pre-lunch (12.30 pm), pre
evening snack (4 pm) pre-dinner (7.30 pm), 2 hours post dinner (10 pm) midnight 3 AM. To
record all the values and staff to inform Dr Mounica (9028220450) directly.

3. To give Inj Lantus 2 units subcutaneously at 10 am once daily

4. To give Inj Humalog 15 minutes before breakfast, lunch and dinner as follows (dose to be
discussed with me before administering to child)

1.5 U ---- 1.5 U --- 1.5 U

Sliding scale :

70 - 200 : 1.5 U

201 - 300 : 2 U

301 - 400 : 2.5 U

>400 : 3 U

5. Hypoglycemia protocol:

Monitor GRBS if child has symptoms of hypoglycemia like excess hunger or sweating or
dizziness.

If GRBS < 70 mg/dl, give 1 tsp of sugar and recheck in 15 mins. Ideally, blood sugar should rise
above 100 mg/dl. If blood sugar still less than 100 mg/dl, repeat 1 tsp of sugar and recheck after
15 mins.

Once GRBS > 100 mg/dl and it is within one hour of meal or snack, child should eat his meal or
snack.

Once GRBS > 100 mg/dl and it is not meal/snack time, child should eat a long acting
carbohydrate like 150 ml milk or small banana.

If GRBS < 70 mg/dl and child is unconscious or drowsy or seizing, give Inj Glucagon 0.5 mg
subcutaneous or intramuscular immediately.
6. If 2 hours post dinner GRBS or midnight GRBS is below 120 mg/dl, child should eat a snack
of 8-10 gm like 150-200 ml milk or small banana.