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May 29, 1999

Daily Care

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?

Answer:

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.

TGL