Our son, in the 3rd grade, has been suffering from celiac and type 1 diabetes for more than five years now. I want to know if there any other ways of taking insulin other than injections, which we consider a very difficult task for the child and the parents since he takes the injections twice daily. He has had many situations in late night and early morning when he has fainted and we had to take him to the hospital. They checked his blood sugar and it had gone down to 30 mg/dl [1.6 mmol/L]. His blood sugar is not well controlled. Before he gets his second shot of the day, it could go up as high as 460 mg/dl [25.5 mmol/L]. These situations drive us crazy. We are looking for other ways to stabilize the blood sugar, especially a permanent way such as using an insulin pump which is not available here. What makes the problem worse is the celiac which keeps him on strictly gluten free diet. Therefore, he often eats rice, which makes the blood sugar rise. What should we do?

So far, the only way to give insulin to a human being is subcutaneously through injections. Recent development on insulin through the skin or the mouth epithelium are promising, even though they are not on the horizon. The lung absorption has recently been questioned due to important side effects and the issue is currently hold, at least for type 1 diabetes. One of the most important problems with all the alternative sites for insulin administration is the reproducibility of the absorption in order to obtain the same fine tuning of dosages and blood sugar excursion we are aiming with subcutaneous insulin shots. You can read a lot more regarding Alternative Insulin Therapy at this web site. As far as your second question, regarding the possibility of stabilizing your small son’s metabolic control, one of the most promising approaches, excluding pumps, which are currently not available in your country, is glargine insulin. Glargine is a new basal insulin that lasts up to 24 hours at a time and makes unexpected blood sugar fluctuations much less likely, especially in situations such as when diabetes is associated with celiac disease. I don’t know whether this new insulin, which is available under the brand name Lantus, is currently available in your country, but you might be able to purchase it from Italy or other neighboring countries.

MS