February 14, 2001
Daily Care
Question from Brampton, Ontario, Canada:
My six year old daughter was diagnosed with type�1 diabetes about five months ago. Why, when she is low (mostly at dinner), and we treat her with the 1 teaspoon of sugar (as suggested), does her blood sugar rise to the 20s mmol/L[ 360 mg/dl]? I went to the doctor yesterday, and she doesn’t seem to know. Is it be possible that she may not need the treatment of 1 teaspoon of sugar and just needs to have her dinner right away, perhaps starting off with a glass of orange juice?
I have taken it upon myself to adjust the insulin by only one-half units because my daughter seems too low or above 12 mmol/L [216 mg/dl] all the time. I cannot seem to keep her in the range of 6-11 mmol/L [108-198 mg/dl]. It seems to work best when I adjust the insulin by one-half either way. However, still I cannot keep her within the target range. Am I doing something wrong? Does it take a year before she becomes a little more stabilized?
Answer:
You didn’t mention how low she is going. If it is 4 or 5 mmol/L [72 or 90 mg/dl], then feeding seems in order. If it is 2 or 3 mmol/L [36 or 54 mg/dl], you should use glucose — have you tried glucose tablets? Each tablet contains 4 grams, and one or two work well.
It is appropriate to make insulin dose change in one-half unit increments as you are doing. Be sure your daughter’s diabetes team is aware of the dose adjustments.
LD
