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Question:

From Pierre, South Dakota, USA:

My daughter, age 12, was diagnosed with Type 1 diabetes a year ago. Her last A1C was 7.3. During the last 5 days her numbers have been running from 250-300 consistently. We have been increasing her insulin. But still does not bring the numbers down at all. She so far hasn't had any ketones. How aggressive can we be in trying to get these numbers down? And could the high numbers be due to changes going on in her body due to puberty?

Answer:

You suggest that the change in your daughter's blood sugars has been dramatic and sudden -- this is not normally attributable to puberty. However, a more gradual requirement for steadily increasing insulin doses is in keeping with pubertal changes. If you have increased her insulin by more than 20% recently, you should check with your diabetes team whether it's appropriate to go on increasing. Are her injection sites healthy -- lumpy sites account for a lot of wasted insulin! Finally, is she otherwise well, any infection could be responsible for a rising insulin requirement.

KJR

Additional Comments from Joyce Mosiman, diabetes dietitian:

I am thinking that perhaps your daughter has just ended the honeymoon period of her diabetes as she is one year out since diagnosis. We often see this abrupt change when the pancreas finally quits producing.

JM

Original posting 22 Nov 97
Additional comment added 28 Nov 97

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