Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
January 27, 2008
Hyperglycemia and DKA
Question from Cape Town, South Africa:
My two-year-old daughter was diagnosed with diabetes on December 3, 2007. We were in hospital for a week to stabilise her levels. When she came home, she seemed to stabilise well but, in the last few days, her levels are constantly high, even at 2 a.m. She wakes up with a reading of 15 mmol/L [270 mg/dl] and is given five units of Protophane plus one unit of NovoRapid for breakfast. Today, her lunchtime level came down to 8 mmol/L [144 mg/dl] and I gave her half a unit of NovoRapid. She seems to climb again at suppertime, and even with a unit of NovoRapid at supper, she climbs again and goes over 20 mmol/L [360 mg/dl] sometimes at bedtime. Her 2 a.m. readings the past few days have also been over 15 mmol/L [270 mg/dl] every night. The diabetes clinic has told me to increase her Protophane from one to two units at 9 p.m. What could be causing these high levels? Is it possible she has not had a honeymoon period and won't have one? The diabetes clinic is worried she is getting sick, but she appears perfectly healthy. What could be causing this?
I think you should discuss with your diabetes team switching your daughter to glargine (Lantus) as the only basal insulin, eliminating the Protophane. Lantus is a non-peaking insulin you normally give at bedtime.This regimen should be completed with NovoRapid at meals before any further action is taken regarding her elevated blood sugars.