From Dr. Joe the Diabetes doctor 4/12/00
And now for controversies on control for children.
The question: Is strict control of diabetes necessary
and feasible?
First remember that Robert Tattersall said years ago that
insulin is given incorrectly because……..
· it is given in the wrong place - under the skin, not liver
· wrong time - after glucose is up
· wrong amounts - sparse for meals and excessive for fasting
and of course, is the risk of Hypoglycemia worth it?
Poor control in the children gives different types of complications early.
· limited joint mobility
· growth failure
· delayed sexual maturation
so that this is added onto the additional risk of poor care.
So how to get around this?
Insulin pumps have far less hypoglycemia than multiple injections.
Lispro has less Hypoglycemia with multiple injections.
Inhaled insulin may even be more effective soon.
Continuous glucose measurements can be analyzed and insulin
patterns changed with this new information.
More tomorrow………
Dr. Joe, the Diabetes Doctor