From Illinois, USA:
My daughter was diagnosed with Type 1 over two years ago at the age of two. We test her blood sugar about 6 to 9 times per day. She is on a three shot per day regimen with Ultralente and Humalog at breakfast, Regular at lunch, and a combination of Regular, Humalog and Ultralente at dinner. Her overall blood sugar control as measured by A1c (6.0-6.5) is excellent. Her hour to hour blood sugar fluctuations are at times quite severe. She also is unable to consistently detect low blood sugar. We therefore feel compelled to frequently check her blood sugar level to avoid serious hypoglycemia. What are the long term consequences of repeated finger pokes, especially in small children? I haven't read about any studies concerning this.
My second question concerns hot baths and effects on blood sugar levels. Specifically we were wondering if hot baths within 2 hours of an insulin injection of R/H and U would speed up the insulin absorption and therefore cause lower than normal blood sugar after bathing.
My first comment would be that your daughter's insulin regimen is quite complex for a four year old and I think this is part of the reason that you feel compelled to do so many blood tests. I don't know of any studies looking at the latter in particular but I have little doubt that 6-9 tests per day in a young child is too many, except on sick days. In my experience it is possible to get adequate blood sugar control in children as young as your daughter with simpler insulin regimens and we normally recommend 2-3 test per day. I am not necessarily advocating that you change but I certainly think that you should make your diabetes team aware of how many tests you are doing.
Hot baths just after injection will speed up insulin absorption.
Original posting 30 Aug 97
Last Updated: Tuesday April 06, 2010 15:08:54
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