September 24, 1999
Hyperglycemia and DKA
Question from Medicine Hat, Alberta, Canada:
Our son was diagnosed with type 1 diabetes 3 1/2 months ago at the age of 2 1/2. When I check his blood sugars at meals and at bedtime, they are usually within the expected range. When I check 2 hours after a meal, the sugars are almost always high: 15 mmol or higher. Is this normal and will it always be like this for him? Right now he takes Humalog and NPH at breakfast and at supper.
Answer:
Blood sugars can peak almost as high as about 11 mmol/l (200�mg/dl) after the meals in diabetic subjects and yet have HbA1c and before meal blood sugar levels within accepted ranges, and have are no further consequences.
I’m wondering whether you could ameliorate the highs by working harder upon the timing of breakfast and supper insulin doses, to possibly overcome both ‘negative’ facts, that your son is mixing Humalog Humalog and NPH (therefore flattening the Humalog absorption profile) and not taking Humalog before lunch.
MS
