My friend’s six year old son was diagnosed with diabetes in August 2005 in Tbilisi. His fasting blood sugar was 136 mg/dl [7.6 mmol/L]. Two hours after breakfast, it was 302 mg/dl [16.8 mmol/L]. His A1c was 11.1 and he had ketones. He was first given 18 units of insulin on August 5, 2005. He was given Novo Nordisk Insulatard in a pen and Novo Nordisk Actrapid in a pen. He was also given NovoRapid.

Ten days after diagnosis, his fasting blood sugar averaged 93 mg/dl [15.2 mmol/L] and his post meal blood sugars averaged 157 mg/dl [8.7 mmol/L]. During the first three months, his blood sugars were not very stable. He has been as high as 404 mg/dl [22.4 mmol/L].

Currently, the boy takes 10 units of Insulatard and five units of Actrapid before breakfast and one unit of Insulatard in the evening. His most recent A1c was 9.6. Is it possible that the boy will recover from this type of diabetes?

First of all, if the boy has type 1 diabetes, it is not possible to recover from it. Since the discovery of insulin, it is possible to manage this disease very well but not to cure it. From what you report, it seem like he has this form of diabetes. To be sure about this, it is necessary to test the autoantibodies (like insulin autoantibodies, islet cell autoantibodies, IA2 autoantibodies and GAD autoantibodies).

However, I think the boy could manage his diabetes in order to be free from any complications. With the schedule he is using now, it is quite common to have blood sugar levels up and down because the type of insulin used are less flexible than other newer ones. You can ask the boy’s diabetes team to switch to glargine plus Regular insulin or a rapid analogue before meals (breakfast, lunch and dinner). Another choice could be the insulin pump, with which it is easier manage diabetes, with fewer episodes of hypoglycemia and a more stable glycemic profile.

AS