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February 21, 2006

Daily Care

Question from Lake Worth, Florida, USA:

My 10 year old daughter was recently diagnosed with type 1 diabetes. She has been getting insulin shots for the past six months. I am really worried because even though she eats the right foods and does everything correctly, her levels are usually high. For instance, today, she was 310 mg/dl [17.2 mmol/L]. The doctor says this is normal, but I can't help but worry constantly. Is there anything she could do besides eat the right foods and monitor herself?


Your child’s diabetes can be frustrating and worrisome at times. Here are some things to consider. First, when are the blood sugar levels too high? Are you checking immediately after a meal (too close to the meal)? Did some of the insulin leak? A single blood glucose value may not tell you very much. Look at that blood glucose in the context of other blood sugars for the day or other blood sugars for that time of day. Look for patterns. Is the blood glucose always high at a certain time or always low? If you can see a pattern, then you can determine a plan: change the insulin dose, add some exercise or adjust the meal plan.

Next, look at your child’s overall blood glucose control. What is the recent A1c (the measure of average blood glucose over about three months)? It could be that the overall blood glucose control is within target, but the individual blood sugar is too high.

Finally, keep asking your diabetes team for suggestions about maintaining blood sugar control. Help them to look for unusual causes of high blood sugar, such as infection or illness, highs following low blood sugar, or stress.