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From Savannah, Georgia, USA:

Our 5 year old daughter was diagnosed with Type 1 diabetes a year ago. We have had a very hard time keeping her glucose levels within her recommended target range of 100-170. She has been on three different insulin combinations and is currently taking Ultralente/Humalog. There is no pattern to her highs and lows and today her endocrinologist told us that he does not know what to do at this point. Is it time to see a pediatric endocrinologist or are most kids this difficult to keep in control?


Each person is different, so it is hard to give one goal for blood sugars. For a five year old, I would still be concerned about preventing as many lows as possible, which would mean striving for a slightly higher blood glucose range than in an older child. If the majority of your readings are within range, then you are doing well. No one can keep all their blood sugars in their desired range. It is important to know what to do when the blood sugars are higher or lower than desired.

I would also recommend that you meet with a pediatric nurse educator, dietitian and pediatric endocrinologist if they are available to you. Children are not little adults, and the care of children and goals for children can be quite different than for adults. A pediatric team may be able to tell you if you are doing well in respect to other five year olds with diabetes.

You also did not mention your child's hemoglobin A1c, which would be a way to look at the overall picture.


Original posting 25 Oct 97


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