Question of the Week

Question

Question :

Posted On : 27 Jan 2022

I have an 11-year girl, weight 25 kg, diagnosed with T1DM in 2007 and on Human Insulin since then but on some erratic schedule and not monitored properly. She was taking regular Insulin 10 units thrice with 16 NPH at night. She presented with a respiratory tract infection with very high sugars but not in ketoacidosis.
I am finding it difficult to control her sugars in spite of giving approx 100 units per day which comes to approx 4 units/kg/day.
I changed the preparation to a new bottle of Insulin and also the brand of Insulin but no help. Currently, she received Human Insulin regular 20, 14, 18, and NPH 28, nil, 24. Her sugars are still in the range of 200-300.

Expert Answer :

Answer Discussion :

M

mohammed suliman

0

check compliance with diabetic diet , investigate for other autoimmune diseases and Mauriac syndrome , check injection technique and injection sites, change to insulin glargine/degludec as basal and rapid acting analogue as bolus with meals

2 years ago

A

Afaf Mustafa

1

pubertal problems or distorted social background

2 years ago

M

mohamed hosameldin

0

Change type of insulin regimen to basal-bolus regimen i.e. give lantus once and actrapid 3 times before meals

2 years ago

H

Hanan Omer

2

This is uncontrolled DM SO need to investigate about other immune disease which ASSOCIATED with DM like thyroid disease. Caeluc disease. Hypoparathyroidism. Pernious anaemia. Adison disease and cutanoius candidiasis

2 years ago

S

Shamsur Rahman Khan

1

May be she have insulin resistant syndrome then you should to use metfomin for reduced the insulin dose plus other help

2 years ago

Answer 1

If she needs to get on to Insulin Lispro and ultrashort acting insulins. It is also likely that she has lipodystrophy and hence injection sites and technique needs to be changed.

Question of the Week

Home

Partner Sites