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Children With Diabetes
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Question:
My daughter was diagnosed with diabetes at the age of 2. She is now
7. I have read Dr. Bernstein's book
Dr. Bernstein's Diabetes Solution
(Boston, Little, Brown & Company, 1997) several times, and would
like to put my daughter on the program. What do you think about it?
I don't remember you ever talking about it in
Diabetes Interview.
Thanks for all your excellent work!
Irene Bozarth, Internet
Answer:
If every newly diagnosed child with diabetes were put on our program
at the time of diagnosis, we would rarely encounter the horror stories
that we hear from nearly every parent. These include the roller coaster
blood sugars with frequent and severe hypos, the need for snacks,
the fear of delayed meals, personality changes and growth retardation.
Furthermore, we find that the "honeymoon period" can be
prolonged indefinitely if blood sugars remain within the normal range
(about 90 mg/dl). Prolongation of the honeymoon period not only makes
diabetes control much easier, but also preserves the pancreatic beta
cells.
Side Note:
When we have adequate technology, beta cells will be removed and
replicated. Injection of a few million replicated beta cells in the
portal vein should be able to cure a patient's diabetes without causing
immune rejection of the cellular material.
When treating children, it is important to scale the effects of insulin
and food upon blood sugar inversely with body weight. While one unit
of Humalog might lower the blood sugar of a 150-pound individual 60
mg/dl, the same amount would lower a 30-pound child's blood sugar
by 300 mg/dl. Similarly, one gram of carbohydrate typically would
rasie the 150-pounder by 5 mg/dl, but would raise the 30 pounder by
25 mg/dl. The effects of insulin and carbohydrates will, of course,
be distorted by any insulin the child is making if he or she is in
the honeymoon period. When we are able to prolong the honeymoon period,
the relatively small requirements for injected insulin are prolonged
accordingly. Obviously, it is essential to use diluted insulin for
small children. For a 15-pound baby, I might dilute insulin with one
part and insulin and 10 parts dilutent. Diluting fluids and sterile
empty vials are available at no charge from all insulin manufacturers.
By using truly physiologic (as opposed to the usual industrial) doses
of insulin and very few dietary carbohydrates, we are able to avoid
the unpredictability and unfortunate blood sugar effects that are
so common.
Richard Bernstein, M.D., F.A.C.N., F.A.C.E.
New York Diabetes Center
Mamaroneck, New York
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