
April 26, 2005
Daily Care, Other
Question from Medford, Wisconsin, USA:
I watch a four year old boy who was diagnosed with diabetes about eight months ago. His blood sugar control is not that good. One day he is at 42 mg/dl [2.3 mmol/L], the next day, 527 mg/dl [29.3 mmol/L]. His average for 30 days was 334 mg/dl [18.6 mmol/L]. They keep increasing his insulin and still cannot keep his levels within a normal range.
The newest thing is that he broke out in hives a couple weekends ago. They put him on a medication for the hives that caused his sugar levels to be “HI” for the duration of this medication. During that time, his insulin increased from 5.5 units of Novolin and two units of NovoLog to seven units of Novolin and three units of NovoLog, plus extra NovoLog between, sometimes an extra unit every two hours. He has been off this other medication for two weeks now and his sugar is still out of control. He is still getting the higher doses of insulin. Can the hives be from giving him too much insulin? I heard from an EMT friend of mine that hives can be a sign of insulin shock; is this true? Any suggestion for controlling his sugar levels better?
Answer:
Hives are not likely related to dosing insulin. It is entirely appropriate to work on increasing his insulin dosing in response to high blood sugar trends. His diabetes team can better direct the details regarding that.
MSB