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Question: From Cleveland, Tennessee, USA: What is your opinion of diluted insulin? My granddaughter was experiencing lows after her fast acting insulin, so the endocrinologist advised diluting. Now, she is having extreme highs, 500s and 600s mg/dl [28.0 to 38.8 mmol/L] in mid-morning. But, she still has occasional lows with only one unit of fast acting at night. We do not have a pediatric endocrinologist. How important is that for a two year old child? Is it typical to be in the upper 500s mg/dl [32.5 mmol/L] one day and below 200 mg/dl [11.1 mmol/L] the next, with similar eating habits for each day? Answer: You are describing very labile blood glucose readings. My personal opinion is that very young children should be managed with a pediatric diabetologist and a pediatric diabetes health care team. Diluted insulin is fine, but it isn't clear why you are using fast acting bedtime insulin in this youngster. There are many excellent pediatric diabetes teams in your state, so, I would suggest a second opinion. SB DTQ-20050123174420 Original posting 30 Jan 2005 Posted to Insulin and Daily Care

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