October 20, 2001
Daily Care
Question from Johannesburg, South Africa:
Our 18 month old daughter, diagnosed with type�1 diabetes four months ago, is currently on an insulin regimen of NPH and Humalog at breakfast and dinner and NPH at bedtime. Two hours after breakfast, she is almost always very high (15-20 mmol/L [mg/dl] ), and although we have tried adjusting the size of her breakfast and her morning dose, nothing seems to help. Her level often falls very sharply so that by lunch she is 3.5-5 mmol/L [mg/dl]. Is there any way to avoid this morning high? Is it doing long term damage?.
Answer:
I’m afraid that I don’t have a definitive answer. There is no hard evidence that the highs or the lows are doing particular damage, but both are obviously best avoided. The best thing that you can do is to take your blood glucose records to your daughter’s diabetes team to discuss a possible change to insulin regimen.
KJR