My daughter was diagnosed with type�1 diabetes about three weeks ago, and since then her blood sugar has been bouncing. More often than not it’s low (45-67 mg/dl [2.5-3.7 mmol/L], she’s having to boost herself two to three times every day to get in range (80-120 mg/dl [4.4-6.7 mmol/L]), and it’s lowest at 2:00-3:00 am. What can I do to prevent the constant lows? Her insulin has already been adjusted seven times.

I know that this is frustrating, and the lower glucose readings are possibly scary to you. However, keep in mind that while her target glucose range is 80-120 mg/dl [4.4-6.7 mmol/L] (which seems a bit “tight” to me), glucose values generally are not considered clinically significant until they are much lower than 60 mg/dl [6.6 mmol/L] and maybe not even until less than 45 mg/dl [2.5 mmol/L] or so. So, I would not anticipate a dramatic hypoglycemic event, such as a seizure, with the readings that you are currently getting.

Since she was diagnosed so recently, she is now entering a stage of diabetes referred to as the honeymoon. Essentially, her pancreas is getting a “second wind” right now and beginning to produce her own insulin (which essentially is Regular insulin), allowing herself to manage the levels better. So not uncommonly, during the honeymoon, the supplemented doses can be decreased to a fraction of the initially prescribed doses.

On-going adjustments in the first weeks is typical! Your daughter is doing what she is supposed to do, but please make adjustments under the guidance of her diabetes team. You don’t want to take too much insulin away too quickly as this may affect the duration of the honeymoon.

DS