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September 16, 2000

Daily Care

Question from Babylon, New York, USA:

My five year old daughter has had diabetes since age two. When I arrive home at night from work, her sugar is always 400-500 mg/dl (22.2 -27.8 mmol/L). I have tried giving her more NPH insulin, but she gets a low reaction that requires a lot of sugar to stabilize, and, now that summer is here, she will get more exercise. I need to know what to do.


This is a difficult problem. You need to consider your daughter’s food intake during the day to see if this is appropriate in terms of both content and timing. Take your records of diet and blood sugar to your diabetes team and discuss the options. One tack may be to consider a basal-bolus

Additional comments from Lois Schmidt Finney, diabetes dietitian:

When do you give her the extra NPH and when does the low occur? It could be that she continues to put out extra glucose to compensate for that low blood glucose 12-15 hours after it happens. I think it best to discuss with your diabetes team as soon as possible.