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Question:

From Pune, Maharashtra, India:

My son is 12 years old and is a Insulin Dependent Diabetic for the past 5 years. At present he is on Actrapid and human Monotard in the morning before breakfast and on human Mixtard before supper. I would like to know how many times in a week should we check fasting and postprandial [after-meal] blood glucose levels. Is it advisable to check urine sugar levels every day also? His diet is essentially vegetarian with eggs.

Answer:

To begin with urine testing is no longer thought to be helpful except as a component in the initial diagnosis. The purpose of blood testing is of course to maintain blood sugar levels between 4 and 10 mmol/L and so minimize the chance of long term complications. How well you have done this can be assessed also by carrying out an A1c test which is a good indication of the average blood sugar over the least three months: your doctor can explain this in more detail. If the result of this test is within 1% of the upper limit of normal, then you could feel that what testing you are doing is sufficient. However as the teen years approach, you should also be think that a more intensive regimen will be needed to control blood glucose levels, by this I mean lispro insulin before each meal with Monotard in the morning and perhaps also at bedtime or Ultralente at one of those times. You might even want to consider an insulin pump. If you move to this phase it will be necessary to develop a more comprehensive profile of blood sugars. At a minimum this would mean 20 or so tests a week, that is before breakfast every day and either before supper or at bedtime as well. In addition it would be important to do an occasional test in the middle of the night and other tests to assess the effect of vigorous exercise or any other unusual event.

DOB

Additional comments from Dr. Lebinger:

Although testing the blood sugar is much more accurate than testing urine sugar, you should still test the urine for ketones if your son's blood sugar is over 300 or he is sick. I suggest you ask your son's doctor about the availability of these urine strips to test for ketones. A high blood sugar with ketones in the urine means that immediate treatment with extra insulin may be necessary to avoid ketoacidosis.

TGL

DTQ-19990909103534
Original posting 30 Nov 1999
Posted to Daily Care

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