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Question:

From Illinois, USA:

My 16 year old daughter has had diabetes for four years. For the last seven months, her numbers stay over 600 mg/dl [33.3 mmol/L], closer to 1000 mg/dl [55.6 mmol/L]. She has been hospitalized numerous times, and in the ER to hydrate her and bring them down. She weighs about 50 kilograms and uses 150 units a day in five injections of Ultralente, Humalog and Regular. She is constantly having severe muscle spasms and has lost 30 pounds, on and off. She gains weight back when she is hospitalized for a week at a time on IV's. She does great on insulin through IV's right into the blood stream, but not subcutaneously.

She has seen a few of the "best" doctors, and they say her only option at this point would be a pump. They are at a loss. I am at a loss and she really is not happy about going on a pump. If I knew the pump would be the answer, I would push it more.

She also has severe asthma, grand mal seizures, food allergies, prescription allergies, migraines, and, lately, severe muscle spasms. They wanted to start her on Glucophage [metformin, a pill for Type 2 diabetes] but, with all the muscle spasms she is having now, they want to wait. We need help!

Answer:

I feel that it would be inappropriate to offer any firm suggestions in your daughter's complex case without having had an opportunity to meet her and to look at her medical history in detail. I am sure that her doctors have explored the possibilities of the insulin resistance syndromes such as Type A or lipodystrophic diabetes and of antibodies to the insulin receptors.

What is not mentioned and what I cant help wondering is whether or not there is a very important psychosomatic component to all her problems. Certainly, this is an aspect that should be explored before starting on a trial of a pump. The first step might be to ask for help from the Medical Social Worker in her diabetes care team.

DOB

DTQ-19991107202929
Original posting 15 Sep 2000
Posted to Daily Care and Other Social Issues

  
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Last Updated: Tuesday April 06, 2010 15:09:14
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