From Loveland, Colorado, USA:
My daughter is 28 and was diagnosed Type 1 at age 12. She maintained fairly good control of blood sugars for many years. She was diagnosed with gastroparesis about 3 years ago. She currently has basically no control of her blood sugar due to the unpredictable digestion rate. She tries really monitoring frequently and using Humalog, but is having many serious insulin reactions and a few extremely high blood sugar periods. Suggestions? So far, her endocrinologist and the internal medicine specialist who diagnosed the gastroparesis haven't been much help.
Gastroparesis is still a poorly understood complication of diabetes that can complicate blood sugar control due to the erratic rate of absorption of foods.
A few thoughts to consider:
- First of all, make sure gastroparesis has been properly diagnosed by radiological studies, and other causes of gastrointestinal symptoms have been ruled out (lactose intolerance, inflammatory bowel disease, celiac disease, reflux, ulcer.)
- Secondly there are several medicines that have been used to treat this disorder. I assume your doctors have discussed the possible use of these medicines.
- Thirdly, since the problem in gastroparesis is slower than normal gastrointestinal function, it is possible that Humalog insulin given before a meal works too quickly for you. You might want to discuss with your endocrinologist possibly giving the Humalog after meals, or whether Regular insulin might actually work better because of its slower time of action. An insulin pump may also be a consideration as you might find it helpful to give the Humalog with meals as a "square wave bolus" (giving it over 30 to 120 minutes rather than all at once). A pump might also enable you to give more frequent, smaller amounts of Humalog during the day to correct the highs. You might have to experiment with several different treatment options before figuring out what works best for you. You should not make any changes without first consulting with your own physician.
Original posting 14 May 1998
Posted to Complications
Last Updated: Tuesday April 06, 2010 15:08:57
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