Recently I’ve established a new way to count carbs, and it has worked rather well. My daughter consumes 100 grams during the day, and 80 grams during the evening. She takes similar amounts of insulin for the morning and evening. Is it unusual for her to be taking the same amount of insulin for morning and evening? I’m hoping she is not dropping low and rebounding during the night. What time is the best time to check her during the night to monitor how she is doing?

Also we do not have a specialist in our area. We do have adult specialist. My daughter is seven. When can we expect to be able to see the adult specialist?

A reasonable insulin dosing scheule will result in a hemoglobin A1c that is in the 7.0 – 8.0 range for a child ages 6-12. Aiming for a goal of 7.0 will minimize her risk for long-term complications of diabetes. A reasonable insulin dosing schedule will also minimize the amount of lability or unexpected high and low blood sugars. There are many creative and varied ways to dose insulin. I would judge the success of the insulin dosing based on the expectations I’ve listed above.

Children that have diabetes do not necessarily need an endocrine specialist. There are many well-trained pediatricians that care for large numbers of kids and adolescents with diabetes very successfully. I would ask your pediatrician about whether your daughter needs the expertise of a specialist or if they are comfortable providing all the care your daughter needs for her diabetes as well as her general health care.

MSB

[Editor’s comment: From the perspective of a parent, you may want to try several different times during the night over the course of a couple weeks to check your daughter’s blood sugar levels. For example, try one night at 2 a.m., another at 3 a.m., another at 4 a.m. Use the results of those checks to make adjustments as needed.

JSH]