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Question:

From Johannesburg, South Africa:

I have a 12 year old nephew with diabetes, Type 1, which he has had from age 5. He is always hungry and if he eats a little too much his sugar level rises to up to 20 mmol/l [360 mg/dl]. How can this be controlled?

Answer:

The question you give raises very important questions regarding (1) your nephew's insulin doses and program, and (2) his (and/or his parents') self-management ability.

Although I do not know anything about your nephew's physical and clinical characteristics (such as weight, height, inulin dose, A1c, hypos, blood sugar profiles) I rather suspect that, especially in view of what you say about his hunger, that he is not getting all the food and insulin he needs even though his blood sugar is usually fine.

I would start off by talking to your nephew's doctor about the possibility of increasing the insulin dose or perhaps starting off again with a much freer regimen (such as, daily Regular and NPH given pre-meal and bedtime in various combinations, and adding extra Regular before the extra snacks he'll eventually ask for). This is an aspect too often understated, although it frequently helps from the psychological point of view. You might find that paradoxically it decreases his hunger.

MS

Original posting 10 May 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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