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April 4, 2006

Hyperglycemia and DKA, Insulin Pumps

Question from Erlanger, Kentucky, USA:

I have a seven year old daughter who was diagnosed with type 1 diabetes a year ago. She is on a pump, but continues to have delayed highs with pizza, regular ice cream and doughnuts. We make pizza every Friday, but don't eat ice cream and doughnuts very often. While we use an extended bolus, we still get highs late at night. Do you have any suggestions?

Answer:

I would need to know what the blood sugar is two hours post meal. That makes all the difference. If the two hour blood sugar is normal, you might need to either spread the insulin over a longer period, or put in a temporary basal that goes overnight when you have pizza. Doing hourly overnight testing to see when the rise occurs will help you decide where to put the insulin increase.

LAD