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From Vermont, USA:

I am a school nurse and I have an 11 year old student with Type 1 diabetes since age 4. This year his noon blood sugar readings have run in the high 300 to mid-400 range. His parents state that the physician knows of the high readings and that these readings are alright -- his glycohemoglobin is within normal limits. They do not want me to talk to the physician. I am concerned that these readings run consistently high. Should I be concerned?


The blood sugar levels, which you report are certainly neither normal nor ideal for a diabetic 11 year old and are also inconsistent with the statement that his A1c levels are in the normal range. You are in a difficult situation; but first of all I would make quite sure that these levels are correct by doing them yourself; i.e., don't accept a value that he has done himself off in the corner of the office. And I would also talk to his teacher to see if he is having any special problems in class or at home. This may be a plea for help in another area.

If this doesn't uncover an explanation I would call the school medical officer and suggest to him or her that he might talk informally to the family doctor or pediatrician concerned. There must be some reason why the parents don't seem to want to have you as a strong ally in their son's care. I would in any case share your problem also with the school principal. You should not, on your own, suggest any changes in insulin dosage.


Original posting 28 Dec 96


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Last Updated: Tuesday April 06, 2010 15:08:52
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