June 8, 2005
Daily Care, Other
Question from Kenya:
My brother has type 1 diabetes. My parents are very poor and cannot afford the care needed to care for their son on a daily basis. A few weeks ago I worked and managed to buy a Freestyle meter that came with 100 strips. We cannot use the strips every day, but are using them for when my brother is sick. I have been reading about this disease for a long time and it’s my understanding that the readings are supposed to be between 80 mg/dl [4.4 mmol/l] and 150 mg/dl [8.3 mmol/L] when taken two hours after meals. My brother’s readings are above 500 mg/dl [27.8 mmol/L]. This has really scared me, but I don’t want to scare him. The insulin he is on is long-acting. The doctor he usually see only knows of one type of insulin, Lente. He is taking 20 units in the morning and night.
I’m looking for someone who can help me take control of his situation. We watch his diet, but nothing seems to work. I’m frustrated. Please help. Send me contacts via e-mail. We need to know what insulin is good for him and how we can buy it or get assistance before it’s too late.
Answer:
It would be wrong and potentially dangerous to give any precise answer to your question because availability of medical supplies including insulin will influence what is the correct advice. However, I am confident that your brother is not receiving enough insulin. It is always difficult to manage without blood testing but symptoms can be used, too. By gradually increasing the daily insulin doses until mild hypoglycemic symptoms occur and then cutting back a little, it is possible to improve control rather a lot. However, using just Lente insulin makes the likelihood of hypoglycemia much greater. It would be better if your brother’s doctor was able to provide some faster acting insulin, e.g. soluble/Regular as well as the Lente.
KJR