August 22, 2003
Daily Care
Question from Johannesburg, South Africa:
My 13 year old son, diagnosed with type 1 diabetes at age 11, is taking NPH in the morning and at bedtime along with NovoRapid before each meal, but this does still not seem to control him well. He is an active child — plays sport — at present weighs only 47 kilograms (103 pounds). Since he is now in puberty, his sugar levels are very high, and no matter what we do, they do not seem to stay down sufficiently. They vary a lot (7- 23 mmol/L [126-414 mg/dl] with a vast variety of peaks during the day, and at 2:00 am he is 9-12 mmol/L [162-216 mg/dl]). Do you have any suggestions as to what we can do now? Is there another type of insulin we can change over to?
Answer:
There is no specific prescription or remedy. I would recommend that you review the information available at this website so that you will appreciate that the problems that you are experiencing with your son are extremely common and have many facets.
KJR
[Editor’s comment: I suggest setting up an appointment with a pediatric diabetes team experienced in the care of adolescents with type 1 diabetes. Your son’s currently treatment plan (including insulin, food, exercise, schedule, etc.) needs a detailed review so that a new one can be devised to meet blood glucose goals and lifestyle issues.
SS]
