My cousin’s seven-year-old daughter was recently diagnosed with diabetes. Her medical tests show the following results: urine sugar – 2%; fasting blood sugar – 250 mg/dl [13.9 mmol/L]; and postprandial blood sugar – 390 mg/dl [21.7 mmol/L]. Doctors here have advised them to give insulin three times a day, 3 units each time. We are very worried. Her grandmother also has diabetes. What should we do? Should we travel to Delhi for treatment? If so, what doctors do you recommend?

The best advice is to start insulin and for them to get education with a pediatric diabetes specialist. Your cousin should consult with his/her own physician to find out who the local experts are and whether or not they will need to travel to a big city if there are no specialists for children’s diabetes locally. If she has symptoms, this cannot wait and insulin should be started without delay. It is the same with meal planning and, most importantly, with blood glucose monitoring at home to be able to know optimally how much insulin and food should be counterbalanced. The two best teaching manuals to learn about all of this are Understanding Diabetes, 12th Edition by Dr. Peter Chase and Type 1 Diabetes: A Guide for Children, Adolescents and Young Adults — and Their Caregivers by Dr. Ragnar Hanas, both available via the Internet.

SB