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October 22, 2000

Daily Care

Question from Abu Dhabi, United Arab Emirates:

I am a mother of three children, boys aged seven and four and an 11 month old girl. About six months ago, I discovered that my second child has diabetes. I was very choked indeed when the doctor first told me. and, still, it is not an easy task to handle. The range the doctors advised and my son's blood glucose levels are, mostly, different. Whenever he eats, the test (I am doing it after meals) will be high, especially if he eats well. I cannot let my son live without food. I need professional advice regarding this matter. For the past three weeks, when I test his blood glucose in the evening, I will find it good, but, in the morning when I check, I will find it very high. Please note that, after the midnight test, he is eating anything unless I find the glucose below 120 mg/dl [6.7 mmol/L]. How I can control this? His weight is 15 kilograms, and he is taking the insulin twice a day. In the morning, around 6:30 am, I give 2 units R and 7 units N, and in the evening, around 7:00 pm, I give him 1 unit R and 5 units N. What is the required range of glucose that a four year old child must not exceed? Is it advised to give extra insulin, if I find it very high?

Answer:

First of all, you need to know that what is recommended is not always easy to achieve and your doctor will know this. Second, you cannot hope to achieve perfect blood glucose control in a four year old who sometimes eats well, sometimes not and some days is very active and others is not. This is normal. What you are trying to achieve is a child who is growing and developing normally with as good blood glucose control as possible without excessive hypoglycaemic episodes. The way this is done has to be tailored to your son’s needs by a doctor (and hopefully a dietitian) who can work with you locally. It is impossible to give specific advice from afar.

KJR