My daughter is 11 years old and has had diabetes for four years. We are beginning to have a lot of trouble controlling her blood sugar. We have been seeing an endocrinologist once a month. They have put her on three shots a day, but we don’t seem to be getting any better. They seem to think that puberty may be a part of the problem. What I need to know is, are there any types of insulin that can be used other than N and R, to help us get better control of her diabetes?

Your daughter is not alone in her difficulties managing diabetes as an adolescent! There are indeed many types of insulin: from ultra-short acting Humalog insulin to very long-acting insulins such as Ultralente insulin. There are also two types of insulin delivery systems including injections and insulin pumps. Utilizing the best variety of these is the job of a good diabetes team. Your physician should be able to help direct you to the best resources for your daughter. Don’t forget, however, that the management of diabetes in adolescence is a difficult and frequently frustrating job for parents, physicians, and the adolescent who has diabetes. With much hard work and patience, plus the flexibility to find the best treatment strategy for her, a successful plan can be found.

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