My six-year-old daughter has had high blood sugar levels since birth. She takes insulin twice a day. Her blood sugar was 275 mg/dl [15.3 mmol/L] last week. Will she have to take insulin forever? Is there any other possible treatment?

Diabetes from birth is extremely rare and she could have a special “genetic” type of neonatal diabetes. Your diabetes team should be able to collect a blood sample and send it to Professor Andrew Hattersley in England for free analysis; it can be done commercially, but is very expensive to process in special laboratories. If positive (abnormal) for this particular potassium channel gene, then there are pills which could replace insulin injections and also improve the day-to-day glucose levels at the same time removing the need for insulin injections. If negative, then likely she will need insulin for life. The ISPAD web site has the exact mailing and processing information for the Rare Diabetes Genetic Study coordinated by Dr. Hattersley and his colleagues in cooperation with ISPAD.

SB