Our three and one-half year old son was diagnosed just a week ago. We live in a small community and our doctors are not up to date on insulin adjustments. We have had blood sugar ranges from 45-518 mg/dl [2.5-28.8 mmol/L] and haven’t contacted any physicians. He has been on 2-3 units of Humalog and 4-5 units of NPH at breakfast and the same numbers at dinner. We have tried keeping his diet similar to track fluctuations but nothing seems to be working. His high level are always around 4:30 pm and lows are middle of the night. Is it too soon to expect normal ranges of 80-200 mg/dl [4.4-11.1 mml/L]? At what levels should we definitely contact a physician? He doesn’t show any signs of highs or lows other than the blood sugar level.

A three and one-half year old should be under the care of a pediatric diabetes team. I talk to families every day for four to six weeks after they go home from the hospital/diagnosis, if not hospitalized. There are changes needed in insulin as well as instructions to give. You need to find a pediatric diabetes team.

LD

[Editor’s comment: I agree with Dr Deeb. It is evident from much of what you say, that you have not received enough education and assistance. Even if you do live in a small town, it would be of great benefit to you and your child to spend at least a few days now (and then at least annually) at a pediatric diabetes center. Taking the time to do this is urgent. Getting control of things now and learning as much as you can will prevent future disasters.

SS]