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July 25, 2019

Daily Care, Insulin

Question from :

My child was just diagnosed with type 1 about five days ago and it has been so hard on her. Her blood sugars have been fluctuating. She was in range, 70 to 150 mg/dl [3.9 to 8.3 mmol/L] this afternoon, but after dinner, she shot up to 297 mg/dl [16.4 mmol/L]. I corrected her with 1 unit of insulin, but I don’t know if that is correct. I tried my best to correct her but I just don’t know how many times I should be correcting her or checking her blood sugar. I checked her an hour or two afterwards and she only went down to 282 mg/dl [16.6 mmol/L]. I gave her her nighttime insulin, but my father told me not to correct her because it’s too much insulin in her body. Was the right thing to do? What should I do next time? How do I correct her high blood sugar? Any tips on lowering her blood sugar? Will high blood sugar harm her? Do I have to check her in the middle of the night? Please help me out.


From: Dr. Stuart Brink

It’s okay to do correcting doses but more important to try to deterine the causes of the blood sugar changes. Bursts of sugar could be from stress, anger, extra food, too little insulin/dosing errors. Usually, you would be taught something called a correction factor, how much insulin to correct, how much blood sugar rise–a typical amount may be 1 unit to correct 50 mg/dl rise of blood sugar. This is very individualized and something you should discuss with your diabetes team. You may want to contact them to get some more specific advice or get an earlier than already scheduled appointment to do this face-to-face.

In the meantime, consider getting both Type 1 Diabetes in Children, Adolescents, and Young Adults by Dr. Ragnar Hanas and Understanding Diabetes by Drs. Peter Chase and David Maahs (also referred to as the Pink Panther book). Both can be purchased on Amazon.com.

Editor's Comments:

Please discuss other ways to lower blood sugar with your diabetes team; these may include adding exercise and/or adjusting her diet to consist of fewer carbohydrates. With respect to checking blood sugars in the middle of the night, you should also discuss this with your diabetes team. Ask them as well about getting a CGM (continuous glucose monitor) for your child. There are several currently available, though not all have pediatric approval, yet. See our page about Continuous Glucose Monitoring.