Voice of the Diabetic

Voice of the Diabetic

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TECHNIQUE KEEPS DIABETIC CHILDREN

OUT OF EMERGENCY ROOM

by Lori Williams

Baylor College of Medicine

Teaching parents a fresh approach to an old medical problem

is helping kids with diabetes stay out of the emergency room. Developed by doctors

at Baylor College of Medicine, in Houston, Texas, the approach, called mini?dose

glucagon rescue, puts control back into the hands of parents.

"Insulin and diet can keep the blood sugar levels of kids with insulin?dependent

diabetes under control most of the time," said Dr. Morey Haymond, a Baylor

professor of pediatrics and director of the diabetes clinic at Texas Children's

Hospital.

"But, when a child can't eat, due to a common illness like the stomach

flu, or won't eat as a form of rebellion, problems with hypoglycemia, or low

blood sugar, can develop. Unfortunately, at that point, parents' options have

been fairly limited and unattractive," said Haymond, also a researcher

at the USDA/ARS Children's Nutrition Research Center at Baylor.

According to Haymond, when an insulin?dependent diabetic child refuses food

or can't eat, parents naturally worry about hypoglycemia. As a result, they

often believe they must force food on a sick or reluctant child, make a trip

to the doctor or emergency room for assistance, or give their child a shot of

a potent hormone called glucagon, which has the opposite effect of insulin.

"Parents often think of glucagon as a last resort or emergency measure

to prevent convulsions when blood sugar levels get dangerously low,"he

said. "The amount normally given must be administered with a 'real' shot

into muscle tissue, rather than under the skin, as is the case for insulin.

It can also cause nausea. Because of this, many parents prefer a trip to the

ER."

The mini?dose glucagon rescue technique sidesteps these problems

by using a dilute solution of glucagon that can be administered just like insulin.

Parents can also monitor the effect of the glucagon using the same sampling

technique used to test for blood sugar when insulin is given.

"This type of shot is much more comfortable for parents and the child,"

he said. "The dilute solution does not cause nausea, so parents might use

it early in the course of a child's illness, saving them and their diabetic

children undue conflict and trips to the ER."

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