Type 1 Diabetes Mellitus - Pediatric Oncall

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
Respected Sir, I want to enquire about my niece. She is 10 years old and suffering from type 1 Diabetes mellitus for last 4 years. Her weight is 30kgs & she is on insulin therapy but her blood sugar is not under control. She is getting 24 units of insulin (6units plain & 18units monotard) in morning at 7am and 13 units mixture in evening at around 8pm.She eats her tiffin in school at around 11am & when I measure her blood sugar at 2.30pm, her sugar comes 250+ invariably. She takes 1 chapatti and sabzi/pickle with her. Her morning blood sugar comes normal around 110 mg%. I want to know how I can further manage her as her insulin requirement is already higher than 1U/kg and her sugar is not getting under control. Recently her eye sight became weak and she was put on glasses -2.5 both eye. If you can, please suggest a way so that I can manage her in better way.
Answer
Since her post lunch blood sugar is high, one would have to increase the morning monotard level by a unit and see what is her blood sugar. Also you need to monitor her pre dinner and post dinner blood sugar level as well as pre and post breakfast to determine the ideal combination of insulin and correct dose to be administered. Read the article on "INSULIN THERAPY IN CHILDREN" on www.pediatriconcall.com for further information: http://www.pediatriconcall.com/fordoctor/diseasesandcondition/ Endocrine_disorders/insulin_therapy.asp Back to All Questions

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