My daughter was diagnosed with type 1 diabetes on February 5, 2010. She now takes insulin injections to lower her blood glucose, which was 27 mmol/L [486 mg/dl] when diagnosed. As parents, is there anything else we can do to allow the pancreas to continue to produce insulin or even increase it? I have read that vitamin D supplements may reduce the incidence of type 1, therefore, would supplementing her diet with vitamin D be of benefit now? Is there anything else that may ease the situation long-term?

Once the diagnosis of type 1 diabetes occurs, there is not much that can be done to prevent it. Tight control of glucose levels seems to help restore some pancreas function and make for more glucose stability day-to-day so many of us use a multiple dose regimen with meal time Humalog, NovoLog or Apidra four or five times each day coupled with twice-a-day Lantus or Levemir for basal insulin effects. Discussing tight glucose goals with your diabetes team would be reasonable so that you and they know your wishes and what can be achieved. Frequent blood glucose monitoring, meal planning and carbohydrate counting all help to allow flexibility, optimal insulin delivery and avoid hypoglycemia.

We also check vitamin D levels, not to prevent diabetes but because of the increased likelihood that vitamin D levels will need supplementation for most people in Western Europe, North America, etc., and because of the association of early heart problems, blood pressure problems, bone mineralization problems, etc. if vitamin D is insufficient. We are finding this commonly abnormal in huge numbers of American kids, for instance, and recommend supplementation. So, if not done, ask your diabetes team to measure the vitamin D levels and review the results. We aim for blood vitamin D levels above 50 ng/ml.

SB