My Mongolian friend has a seven year old girl with diabetes. She injects her daughter every three hours. She does not have anything that measures blood sugar levels, etc. She just gives the child the same dose each time, regardless. Is this frequency of every three hours normal? Or, is it the result of faulty medical advice? The medical system/knowledge in Mongolia is very under-developed.

It is not the way that pediatric diabetes care is done in the United States, Western Europe, Canada, Japan, Australia, etc. We generally use “intensified insulin regimens or pumps” to provide insulin in a more physiologic fashion, before meals with some basal (background) insulin as well. This is done four to six times each day. But, all the insulin is provided via written algorithms as we base such treatment decisions upon frequent blood glucose monitoring results. But, a lot would depend upon what type of insulin is available and whether or not there is the possibility – because of costs – of blood glucose monitoring. Here, in the U.S., we have many charitable organizations, i.e., Kiwanis, Rotary that might provide free blood glucose monitoring, lancets and even blood glucose strips as well as insulin and insulin syringes/pens to such a child from Ulaanbaatar. Ulaanbaatar may actually have such organizations there already. You should find out more information, what is available and what might be needed so that you can know what might be requested, provided, etc.

SB