May 29, 1999
Question from Wilkes-Barre, Pennsylvania, USA:
My 10 year old son has had diabetes since he was 6 years old. I have an extremely hard time getting good control of his blood sugar. It's like a roller coaster: if it's not high, it's low. His A1c reading is usually around 8.6 or 8.4. Is this unusual? I do keep in touch with his diabetes team but you can never tell when a ten year old is going to be active. Also I was once told that if I raised his Humalog to 1/2 of the NPH I could probably get more control instead of giving him 3 H 10 N to give him 5H 10N. I know you don't know his weight but does that seem like a way to get better control, by balancing his insulin?
Although there are some approximate formulas to help decide on an insulin dose, nothing takes the place of individualization. You do not mention if your child is on at least 2 injections a day. The goal is to balance food, exercise, and insulin to maintain blood sugars as close to normal as possible. You need to work closely with a diabetes team that includes a pediatric endocrinologist, dietitian, nurse educator, and possibly a social worker or psychologist.