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August 18, 2002

Daily Care, Pills for Diabetes

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Question from Gaza, Israel:

According to our pediatrician, my nine year old son has had either type�1B or type�2 diabetes for exactly two years now. (We don’t have any advanced blood tests here in our town). During the first year, we were able to control his blood sugar by diet only, and his hemoglobin A1c results were excellent (4.7-5.3%), but about eight months ago, he started having slightly elevated blood sugar levels (200-250 mg/dl [11.1-13.9 mmol/L]) without any ketones in the urine, even if he is sick. Our general pediatrician recommended that he should take one-half tablet of Glucophage with each meal which was increased one tablet in the morning and with dinner, and one-half tablet at lunch, and his results have been excellent. His last A1c was 6.2%. I have several questions:

Is it safe for a nine year old child to have Glucophage or any other oral medication?
Does he have a good blood sugar control?
Sometimes his fasting blood sugars are 140-160 mg/dl [7.8-8.9 mmol/L], but after breakfast he’s okay. He still has blood sugar levels in the 200s mg/dl [11.1 mmol/L], but they are not too often, and he is always without any ketones. I’m worried about this. Is there another medication that he can take to regulate his blood sugar better?
Everybody is saying that he is quite thin; what can I do to get him gain some weight?
If he exercises or does any kind of sports, will his control be much better?

Can you give me websites for healthy meal plans? How do you count the carbohydrates needs for my nine year old son?

Answer:

From: DTeam Staff

It sounds like he may do better with some Lantus (insulin glargine) or NPH at bedtime coupled with the Glucophage [metformin] during the day. Keep working with your doctor and do lots of blood glucose testing since this will tell you how you are doing and what else you might consider. Go to the American Diabetes Association website and there will be many pieces of information for you including an excellent children’s site called Wizdom. It is free. Also the Juvenile Diabetes Research Foundation website and, of course, this website.

SB