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May 29, 1999

Daily Care, Insulin

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Question from Raade, Norway:

My friend’s daughter has had Type 1 diabetes for a couple of years now, and now she has developed antigens against insulin. They have not been able during this time to get her insulin doses stable. She has both too high and too low all the time. But now she doesn’t react to the insulin. And she’s been hospitalized for a while now. But since this isn’t that often seen in our small hospitals here, she doesn’t get any answers about what to do about this. And the mother also wonders about this antigen, she says that the logical thinking here is that the body makes new kinds of anitgens all the time as in other deseases, but the doctot says that it doesn’t, that it only creates this one antigen and that’s it. Is this true?

This little girl is only 9 years old, and don’t function at all anymore. She’s more in the hospital with stomach aches and insulin shock or the oposite than she is with her friends and at school. This is a very strong little girl, but she’s really getting tired now. So far she has gotten both synthetic, and ox and human insulin and are now resitant to them all. What can they now do for her? Her level is also constantly around 10-20 all the time, so her kidneys and liver is working overtime all the time. But during the night when she’s asleep it can drop down to 2-3 and she gets bad.

Answer:

From: DTeam Staff

Your friend’s daughter very clearly needs the help of a paediatric endocrinologist. What you describe should not be happening; but it often takes in addition to the doctor the help of a nurse educator, a nutritionist and of a medical social worker over quite a long time and many follow up telephone calls to get things right.

DOB

[Editor’s comment: In the answer that has been sent back to the original writer, Dr. O’Brien gave the family the name and phone number of a specialist in Norway for them to contact.

WWQ]