Ask the Diabetes Educator Archive

9/21/04

Q:

My Mom has been diagnosed as an uncontrolled "brittle" diabetic. Her physician states, "that it doesn't make sense" as her blood sugars fluctuate so much and drops frequently. Recently she was being trained on a new insulin pump (she had one before) and during the training we learned about her "sensitivity level" and she is not 50 per one unit or 15 carbs for one unit (as the previous trainer did not explain sensitivity, but rather stated the numbers above) we are having trouble getting a more accurate sensitivity (it seems more 75-100 points per unit and 25 carb for one unit) still it is up and down.

I guess my question is why are some people brittle and uncontrolled and what is your advice to help my mom better control her blood sugars. Thank you for any advice you have, we are trying to adjust and figure it out, but any information is helpful. Note also she has seizure disorder on anti-seizure meds. does that make a difference?

A:
The anti-seizure medication may be a contributor; read the warnings and ask the physician about it. The less insulin needed, the better. I have had patients more sensitive than your mother. It requires a thorough diet analysis matched to blood sugars as monitored throughout the day to look for some patterns. She could be experiencing other physiological shifts due to age, etc. that may be "kicking in". To more thoroughly answer this, she should have her food record, labs, blood sugars and medical history/lifestyle reviewed by her health care team.



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