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From Huntsville, Alabama, USA:

My seven year old daughter was diagnosed with diabetes (type 1) in February 1996. Up until the last month or so we had little trouble controlling her blood sugar levels (last A1C was 6). Lately we can not seem to keep her levels below 200. Even in the mornings, when she was never high, she wakes up with high readings.

Example 1. She was 82 before her bedtime snack the other night and we gave her a "normal" snack. She was 190 the next morning before breakfast.

Example 2. She reads 100 in the morning (give 1.5R and 6N) and by mid afternoon she is at 350. A few weeks or so ago this was the correct dose! I was under the impression that when she was really high, i.e. 300 or higher, and she tested negative for ketones, then she did not need more insulin - just water and physical activity would bring it down. Is this true? Also, should we limit her food intake? She only eats good food (meat, breads, veggies, etc.) but she eats a ton! As long as she is hungry and eating good food I hate to limit it; she has no fat on her at all.


Your daughter has now had diabetes for 6 months and it's quite possible that the erratic sugars are related to the end of her honeymoon period. It is common for this fluctuation to occur and you shouldn't think that things will always be this difficult. You are right not to give extra insulin every time you get a high reading because this could lead to her sugars swinging up and down. It's better to look for a pattern in her sugars over 2-3 days and discuss this with your diabetes team.

As far as food is concerned, you shouldn't starve your daughter but nor should she eat very differently from day to day. You should aim to keep the distribution of carbohydrate fairly similar. Any increases (sanctioned by your diabetes team) will then be taken into account in calculating her insulin doses.


Original posting 13 Aug 96


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