Question from Staten Island, New York, USA:

Our daughter is five years old, diagnosed with type 1 diabetes in May 2003. She is on Humalog, 1 unit for every 30 grams of carbohydrates, with a correction factor of 1 unit for every 125 mg/dl [6.9 mmol/L] above 150 mg/dl [8.3 mmol/L]. She currently takes 4.5 units of Lantus in the evening, which we increased two weeks ago, from 2.5 units. Her sugars still are in the low 300s (mg/dl) [around 17.0 mmol/L] between 3 a.m. and 5 a.m. in the morning, no matter how much Lantus we give her. She goes to bed with normal blood sugars and is okay all day. I end up giving her a correction at either 3 a.m. or 5 a.m., then, she wakes up with normal blood sugars. If we do not give her the correction, she wakes up with high blood sugars. We consulted her pediatric endocrinologist, whose reply was that she needs to be on the pump. This has been a sore point between us, because my wife, my daughter and If do not want her on the pump yet. My daughter is afraid of having something stuck in her all day, although she accepts getting injections. My wife and I feel she is too young to know how to manage a pump and alarms and stuff like that. Besides, we do not feel this is the problem since her sugars are normal all her waking hours. We feel that Lantus is just not for her. Her endocrinologist insists the Lantus is effective since her sugars are normal during the day. She also feels the Lantus is working since she is waking up with normal sugars. She says the Humalog we give her at 3 a.m. has no effect on her morning sugars since it has worn off by then. What do you think?