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Question:

From England:

My 12 year old daughter was diagnosed nearly three years ago. Just recently she has had trouble in the morning. She has 30 units of a 50/50 mix and even without breakfast her sugars rise all morning and only drop around lunchtime. Are growth hormones 'active' in the morning thus making her body resistant to the insulin? Soon after lunch it's as if all the insulin is released within a few hours and she is low all afternoon. If she reduces her dose she doesn't get low enough for lunch. She has started to check her sugars up to fifteen times a day to be sure when she can eat. Any ideas or thoughts on growth hormones interfering with insulin absorption? Thank you.

Answer:

Although the onset of puberty does increase insulin needs, I think it very improbable that this effect acts only in the morning. I would really like to know a good deal more about your daughter's diabetes before trying to explain what her blood sugars have been doing. I am puzzled for example by what you might mean when you talk about a '50/50 mix' for the morning insulin dose. If this refers to a Regular/NPH mix it is unusual as the commonest ratios for children are 1:3 to 1:5 although some people use a premixed 3:7 ratio. I also have difficulty in believing that your daughter really needs to do as many as fifteen blood sugars a day and wonder to what extent you are able to supervise this procedure as well as the insulin administration.

I think that this is another way of suggesting that you would all be helped if you could take your daughter to one of the centers in the UK that has a diabetic team for children with diabetes. Such teams normally consist of a physician and also a nurse-educator, a nutritionist, and a medical social worker, and they can be extremely helpful in sorting out the kind of problems your daughter seems to have.

DO'B

Original posting 25 May 97

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