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From St.Anthony, Newfoundland, Canada:

My 16 month old cousin was just diagnosed with type 1 diabetes, and her sugars are running in the 20s mmol/L [360 mg/dl] and 30s mmol/L [540 mg/dl] and reading high. She is only getting 2.5 units of insulin, and I was wondering if she should be getting more. Tonight, the glucose meter was reading high, but she wasn't given any extra insulin to bring her sugars down. Is this normal? What is the protocol is for a child that age?


On the face of it, your small cousin would certainly seem to be getting too little insulin, but, without a good deal more information, it would be inappropriate to suggest any specific remedy on the Internet. It is really the responsibility of the parents to discuss this with the paediatrician, and, if necessary, to ask for a referral to a center that can offer team care with not only a diabetic specialist doctor but a nurse educator, a dietitian, and a medical social worker.


Additional comments from Dr. Stuart Brink:

Not enough information provided to answer these questions. This child and parents should be working closely with an experienced pediatric diabetes team with frequent blood glucose monitoring to answer such questions. Food inconsistencies are quite common in toddlers and often the cause of much variability in day to day BG readings. Also, generally it is wise to use small doses of insulin several times a day rather than just once a day in an effort to avoid wide swings in insulin level for the same reason. All should be done based on BG responses, looking for BG patterns etc.


Original posting 14 Nov 2003
Posted to Hyperglycemia and DKA


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