From Illinois, USA:
My 7 year old son has Type 1 diabetes. For about eight months, he has been taking Humalog (lispro) instead of R insulin. Is this new insulin more similar to human insulin than R? He seems to be in better control but now his team wants to include him in an experiment for a human growth factor hormone to be used instead or conjunction with his insulin once he turns eight. I am very wary about this. I've heard the growth factor hormone can sometimes lead to vision problems. Could this eventually lead to insulin resistance in later life?
Also, his most recent A1C was 8.2 even though his monitor says his average is 128 mg/dl [7.1 mmol/l] over the last 30 days; it's even lower for the past 14 days. They want his A1c in the 7 range. I'd love that, but it seems a little unrealistic to expect so much from a young child. It seems a little dangerous too. What do you think?
Lispro insulin [Humalog® brand] is not more similar structurally than Regular insulin to human insulin. In fact, Humulin and Novolin brands of Regular insulin are identical in structure to human insulin. Humalog is actually slightly different structurally. When injected subcutaneously (under the skin), Humalog works more quickly than Regular insulin. It gets into the blood faster so the amount in the blood increases faster, similar to the way insulin is released by the body after food.
I assume you are only testing your child's blood sugar 4 or 5 times a day, probably before meals. The reason that the Hemoglobin A1C is still high is that your child's blood sugar is probably higher 1-2 hours after eating. Hemoglobin A1C reflects an average of all the blood sugars during a 2-3 month period.
I think it has become clear that it may be impossible to achieve normal hemoglobin A1C's in most individuals, especially children, without increasing the risk of low blood sugars. Some people seem more prone to low blood sugars than others. I think each individual should strive for the best blood sugars possible while avoiding frequent or severe low blood sugars.
IGF I treatment is still experimental in children with diabetes. It may improve blood sugars in difficult to control individuals, but also can have some side effects. It is very important that, before you agree to participate in any study, you sit down with the doctors and ask all your questions regarding possible side effects and benefits before you decide to participate.
Original posting 17 Aug 97
Last Updated: Tuesday April 06, 2010 15:08:54
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