September 9, 2003
Daily Care
Question from Pennsylvania, USA:
My 13 year old son was recently diagnosed with type 1 diabetes and takes Humalog with NPH. If his blood sugars are in range (80-200 mg/dl [4.4-11.1 mmol/L] ) at breakfast, lunch, dinner and bedtime, but are, at times 220-300 mg/dl [12.2-13.7 mmol/L] without ketones) between these times (i.e., two-three hours after meals), is there cause for concern? If so, what can be done to correct this? One endocrine fellow suggested as long as the pre-meals are in range, there is no worry about the in between highs — as long as they don’t stay there.
Answer:
You cannot judge control only on individual blood sugars readings because what matters is the total time the blood sugar is above the normal range. The hemoglobin A1c is the first court of appeal to measure control, and quite soon there are likely to be continuously reading sensors linked to meters and ultimately to insulin pumps that in turn can be down loaded on to computers like the Palm Pilot which will both store and assess the data. The GlucoWatch III will do a lot of this, but it is rather expensive. That said, the blood sugars levels seem a little high before dinner.
DOB
