My three year old daughter has had type 1 diabetes for 18 months, and I am having difficulty potty training her. She urinates three or four times an hour, even if her glucose level is in range. She never has a bowel movement in her underwear, only urine. She does pretty well at home, but has a hard time when not near a toilet. Is this normal for a toddler with diabetes?

I don’t think you should be concerned that at age three, your daughter is not yet toilet trained for urine, regardless of her diabetes diagnosis. There is no doubt that having higher blood glucoses leads to increased urination and fluid losses and can make the whole toilet training experience more prolonged and frustrating for everyone.

You did not indicate what her insulin regimen is or what her hemoglobin A1c is. However, the addition of a longer lasting insulin might help matters a bit. In a child of this age, I would consider Ultralente before Lantus (insulin glargine) [ED: Lantus is recommended for children 6 and over]. Be certain to address your questions and concerns with your daughter’s diabetes team.

DS