Dr. Shaikh Sadaf
Endocrinology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 2 year old daughter was diagnosed diabetic and I am giving four units of Lantus and two boluses Novo rapid for each meal three times. But still, her sugar levels are not in control. We give her low-carb and proper diet. What should we do now as none of the doctors we consulted are able to guide us in the proper direction?
Hello,
Welcome to icliniq.com.
I just read your query. From what you have mentioned, it appears that your daughter has insulin-dependent diabetes mellitus and you are concerned about her high blood sugar. I would request that you record for three days her fasting blood sugar (FBS), two hours post meals blood sugar (PPBS) and before bedtime blood sugar levels and get back to me.
Hope you will do the needful and get back.
Patient's Query
Thank you doctor,
Her three days fasting blood sugars are 160, 110 and 204 , two hours post meals were 196, 284, and 255 and before bedtime, it was 110, 122, and 66. Today, we have also got the blood and urine sample reports. Kindly check and advise whatever is suitable. I do not know why her numbers are so high at times and then it drops too low.
Hello,
Welcome back to icliniq.com.
I reviewed your daughter's blood sugar values and her reports (attachment removed to protect patient identity). I would suggest that you give her the same dose of Lantus as 4 units once daily. Regarding Novo rapid (insulin as part), give her 2 units at breakfast time, 2.5 units at lunch time and 2 units at dinner time. So, I have basically increased only her lunchtime insulin Novorapid by 0.5 units. Our target is not too tight glycemic control at this age. So, any value near 200 is fine for her now. Watch for symptoms of hypoglycemia at all times especially at bedtime.
Her reports are good and like wise she does have a high HbA1c, but we can take care of it with a low-glycemic diet like oatmeal, whole grains, carrots, peas, and vegetables. Give her less of foods like lentils, rice, cheese, etc. Try to give her four to five glasses of water preferably. Avoid juices and junk food. With age, she will have better blood sugar control.
You have managed quite well so far. If you have any problems or doubts do get back to me.
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Endocrinology
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