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October 4, 1999

Daily Care, Honeymoon

Question from Kuwait:

My son has had Type 1 diabetes for 4 years. He is 7 years old right now. His problem is that his blood sugar readings are not stable. He may read 300 in the morning and 400 in the evening, while sometimes his readings shows 60s in the morning and 90s in the evening. You may read that his morning reading is high and the evening is too low and visa versa. He is having a mixture of Actrapid and Monotard as follows: morning: 4 units of Actrapid and 16 units of Monotard; evening: 2 units of Actrapid and 2 units of Monotard. His weight is about 27 kilos. By the way, we used to measure his blood sugar twice or thrice a day. My questions: Is there any kind of medicine or different type of insulin in order to stabilize his blood sugar readings? Is there a new device to measure the blood sugar without punching the fingers? Is there a possibility of transplant and what is the percentage of its success?

Answer:

Your son is probably now coming out of the honeymoon period when he will be making less of his own insulin. When the honeymoon period ends, it becomes more difficult to control the blood glucose and can be quite variable.

It seems as though your son is on a reasonable dose of insulin. If only dealing with insulin types and doses would solve the problem of good control, diabetes care would be really simple. Unfortunately, good control is also dependent on the routines of regular diet, exercise, timing of insulin, etc. Perhaps you might need to look at these things again to see if there is any pattern to his blood sugars. Sometimes, a food and activity diary kept along with your blood glucose readings is a useful tool at working out what is going on.

Unfortunately, there isn’t a noninvasive blood glucose monitoring device yet, but check out a thing called the GlucoWatch which may be available in the next year or so.

Finally as far as I am aware, no one is performing pancreas transplants in children, and islet cell transplants are still experimental in adults, not done yet in children.

JS