My son has type 1 diabetes and has been on insulin for about 18 months. Earlier, he was taking human insulin 30 but since his A1c went up, the doctor has recently put him on NovoMix 30. My son feels lethargic and does not get up early in the morning for his morning walks, etc. He is also not attending to his studies properly as he could not qualify in his math compartment examination despite appearing twice in the recent past. How can I get my son back on track like he was before his diagnosis?

Also, I would like to know the latest conclusions about stem-cell research being undertaken by some renowned doctors in this direction. And, can my son perform some indoor exercise to keep himself fit and better concentrate on his studies? I am really worried about him since he’s at the turning point in his life where he needs to start his career journey and he has been facing some hurdles.

You did not give enough information about how often his blood glucose levels are being monitored. Most pediatric/adolescent diabetes specialists believe in tight control of glucose levels to try to avoid long term complications. So, this translates to optimal monitoring with before and after meal blood glucose values, if this can be afforded. This would allow you to decide how much NovoLog or Humalog is given before each meal and to create bolus algorithms accordingly for corrections of high and low values as well as carbohydrate coverage of the meal intake. Also, you would need either Lantus or Levemir provided (mostly twice-a-day in our practice but sometimes once-a-day will work) for basal insulin needs and overnight coverage. This, too, is decided based upon actual blood glucose profile review. We do not recommend premixed insulin for children, teenagers or young adults since we believe that this compromises control and flexibility on a day-to-day basis. A lot would depend upon what the blood glucose monitoring results in your son are showing as to exactly how one might respond. He should be feeling better than you describe, so you may want to go back to your diabetes team for further in-depth consultations about meal planning and monitoring. Also, you may want to consider another opinion by another diabetes team if he still is not feeling very well.

As far as stem cell research, this is still in its infancy and, while promising, is not yet safe for full-scale use. Research is continuing.

SB