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June 16, 2000

Daily Care

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Question from Armenia:

My 9 year old daughter was diagnosed with Type 1 diabetes after being admitted to the clinic in a diabetic coma. After several days in the clinics, we received results of her Hemoglobin A1c test which was 11.5%. Now she is getting 2 Units of R and 1 Unit of NPH per day. She is also following a meal plan. Analysis of C-peptide shows a level of 0.7 right now. I would greatly appreciate if you could give me as much as possible information on the possible methods of further rehabilitation courses and places (clinics, camps, other institutions) for children with diabetes. Also, please, give me hints about the appropriate sources of assistance that could be used for sponsorship.

Answer:

From: DTeam Staff

I suggest you look at the camps page for Children with Diabetes. Each camp will have its own policy for scholarships, so it’s best to contact individual camps yourself for more detail.

TGL
Additional comments from Dr. Stuart Brink:

I am glad that your daughter has done well. This sounds like a very small dose of insulin. In our clinic we usually use three or four injections of insulin right from the diagnosis so that we try to rest the damaged beta cells in the pancreas. The most important thing would be to learn as much as you can about modern diabetes treatment. I do not know exactly what tools and equipment are available in Armenia but the Internet has lots of information about diabetes especially at sites like www.jdf.org and www.diabetes.org and childrenwithdiabetes.com.

We usually recommend blood glucose testing before each of the three big meals and also in the middle of the afternoon as well as at bedtime so that this information can serve as a guide to how much insulin to administer, how much food to give and what is going on with exercise. If you cannot afford the cost of strips and the insurance does not provide the strips, then you can use visual strips (20-800 strips, for instance) and cut them into three or four thin strips to save money.

Urine testing can also be used even though it is not quite as accurate as blood testing. Anything you use for routine testing several times each day will be enormously helpful.

Consistency of food for meals and snacks is also important. Trying to stay to eating at the same time each day allows you to know how much insulin to give and when adjustments are needed for activity.

Working closely with your diabetes doctor and working with a diabetes team that includes a nutrition specialist will also be very helpful. Hemoglobin A1c should be done at least every 3-4 months. Eye checks should be done by an eye specialist annually. The rest will depend upon how well the medical system in Armenia is functioning.

I hope that this will give you hope to get information and to absorb as much information as you can so that this can be applied in your situation.

SB