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Question:

From Maryland, USA:

Some of the answers you have given to questions asked give me the impression that you all feel multiple daily injections are the only way to go. My son was diagnosed about 6 months ago, and put on two injections a day R and NPH. His A1c last time was 5.7; for that lab an average of about 100 or 99, but his blood sugars are still periodically high one hundreds to low two hundreds if tested at odd times not usually high when testing at meals or bedtime.

Is it typical to stay with two shots a day if the blood sugar averages for each test time (breakfast, lunch, dinner, and bedtime) are good and the A1c is good or is it worth it to try the multiple daily injections anyway to keep blood sugars more even throughout the day?

We have a good diabetic team and I think they are pretty willing to let us do what we feel comfortable doing so I am curious if you feel this would be a better course to be on? My son is still in rather a honeymoon period taking 3R and 3N breakfast and dinner sometimes a unit less of R sometimes a unit more depending on if he is playing soccer or running, etc. I do not know if being in the honeymoon period negates doing multiple daily injections or not.

Answer:

First of all, I never tell people to fix what isn't broken. Most do benefit from multiple injections, but early on in diabetes especially when the dose is very low, a less rigorous schedule works just fine. The bottom line, control the blood glucose, avoid extremes of glucose and keep the A1c okay. For established diabetes, bolus (that is, meal-time) insulin seems to work best. This provides the most flexible method to give insulin. For your son now, it doesn't seem necessary. Be willing to do what it takes.

LD

Original posting 9 Mar 1999
Posted to Daily Care

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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