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November 9, 1999

Daily Care

Question from Ankara, Turkey:

My six year old daughter was diagnosed with "diabetic ketoacidosis" 4 months ago. When we visited to hospital, her blood sugar level was 675 mg/dl and ketones 3.77 mmol/dl. Before her diagnosis, she had influenza with a fever nearly 39�C. She stayed at hospital for five days. After treatment, she was discharged from hospital with Insulin Mixtard 30HM (12 units at morning and 6 units before dinner). In the next 25 days according to her blood sugar level, we gradually decreased her insulin doses 2 units at morning and 2 units before dinner. We could manage her blood sugar level well till last week. However, her blood sugar level started to increase 215 mg/dl before breakfast and other values is between 150 to 200 mg/dl at day time. Is she a Type�1 diabetic patient and started to leave the honeymoon period? If so, can I do anything else except to adjust Insulin doses?

Answer:

You are possibly correct or the latest increase in insulin requirement may be temporary and due to a viral infection. You are doing exactly the right thing by monitoring her blood sugars and modifying the insulin appropriately.

KJR