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October 9, 2001

Daily Care

Question from Sheridan, Wyoming, USA:

I am now 31 years old, I have had type 1 diabetes for 24 years, and I have I have had no complications so far. I had pretty good control until about two years ago, and now my A1cs are 12 to 12.5%, and my blood sugars are usually in the 230 mg/dl [12.8 mmol/L] range. My lows are very low (30-40 mg/dl [1.7-2.2 mmol/L]. I am on a sliding scale of Humalog with Lente morning and evening, and I am careful about what foods I eat. I should also include that in the last two years I have moved several times, we just recently moved again, and now both my 10 year old daughter (who also has type 1) and I are having more blood sugar trouble than ever. Any suggestions would be greatly appreciated. This tired and sluggish feeling is awful, and I want to regain and maintain control. How do I regain control of my diabetes?

Answer:

Your desire to improve your control is great! It is important to make changes now and not let any more years of less than optimum control slip by. I would suggest finding a compassionate physician who can assist you. You might start by contacting the American Diabetes Association in your state for a referral to a diabetes program in your area. Their physicians and diabetes educators can assist you in making positive changes and regaining control.

MSB

[Editor’s comment: The trend these days is more physiologic and uses a multiple injection regimen with Humalog or Novolog at meal times based on carbohydrate counting and a basal insulin such as Ultralente or Lantus (insulin glargine).

Insulin pump usage is also an approach to consider. See Is pumping for you?.

Please do seek out an experienced diabetes team and explore these latest treatment options.

SS]