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Daily Care

I’m 16 years old, and have had diabetes for almost two years. I switched to Intensive management, and got my HbA1c in the 7’s (7.0-7.4). With this better control, I have been going low very frequently (5-8 times a week), and have now been considering a pump. How long do you usually recommend your patients to try a treatment option before switching to a new one?

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My five year old daughter has had diabetes for almost a year. They increased her food and insulin. However, she started dipping down so low that she had her first low blood sugar reaction. I was scared, so I stepped her insulin dose down. Now she is taking less insulin than before the carb increase. Why is that? How can I watch her better at night?

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If a patient with diabetes who is taking glipizide came to you after two weeks and the blood sugar level was still not well controlled, would the next step be to Increase the dose of glipizide, replace with insulin. or replace with metformin?

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I assume my two year old son, diagnosed with type1 diabetes six months ago, is still in his honeymoon period because of his low insulin doses. He wakes in range, but occasionally he will run high and just keep going higher and wake high the next day. I can’t figure out why this happens. Could it just be due to the unpredictability of the insulin?

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My child eats three meals per day, and her before meal glucose levels are within normal range, but sometimes her two-hour postprandial blood glucose is high. Is it normal? What is the normal range for postprandial glucose levels?

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I am on about 15 Units of Lantus at night with 5 Units of NovoLog. What would be a good target for my before breakfast blood sugar?

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My father began serving a nine month prison sentence, and when he reported to the institution, he brought all of his diabetes supplies and medications. Since then, all of his medications have been changed, he has only had one test in seven weeks, and he is feeling very lethargic and weak.Any information or direction would be appreciated.

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For several years, I have had frequent high blood sugars in the morning. When this started, I do not recall changing insulin doses. The levels, however, are not always high, and so I hesitate increasing my insulin dose at night. Do you know of anyone in the Toronto area who could put me on a CGMS to help me determine exactly what is happening at night?

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I believe my 14 year old daughter is now over her “honeymoon” phase. Recently when she takes her fast acting insulin, and then checks two hours later, it is as if she hasn’t even taken any insulin, even though we increased her Lantus and NovoLog in the last couple of days. Do you think she is becoming insulin resistant or are we just experiencing the end of the honeymoon?

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If the child has to take insulin for carbs, why are low carb diets such as the Atkins dangerous? How many carbs should a child with diabetes have in a day? We want to maintain level blood sugar and decrease the amount of insulin she has been taking.

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