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August 30, 2000

Tight Control

Question from Limerick, Ireland:

My sister's first baby (boy) is two and a half years old and was diagnosed with type 1 diabetes last year. Since then, they have worked very hard to try to stablise his sugar levels but haven't been able to do a good job. More recently, at night he goes quite high, and the doctor has put him on two insulin shots a day. The second contains only Actrapid insulin. Now his figures are very erratic with several lows occurring day and night. They have tried everything. Is there anything to help? Is there a book showing example sugar levels for a day/week for a child this age with related insulin levels and food applied? Is there anyone else in this predicament?

Answer:

Managing diabetes in such a young child is often quite difficult. I can’t offer specific advice about insulin doses and regimens, but it is quite common to be able to get good overall control by giving just some soluble insulin (e.g., Actrapid) before the evening meal. I think the best thing your sister can do is keep careful records of your nephew’s blood sugars and show these to the diabetes team looking after him. This information will help them to decide the best solution.

KJR