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Lisa Bolduc-Bissell RN, CDE
Lisa graduated from the University of Vermont School of Nursing in 1996. Upon graduation, she worked as a school nurse for a year and then worked at the Joslin Diabetes Center in Boston from 1997 to 2000 as a diabetes nurse educator (general diabetes education, pump starts, program development, manager of RN/CDE's). From 2001 to 2006, Lisa worked at the Regional Diabetes Center at Fletcher Allen Healthcare, a regional teaching hospital associated with the University of Vermont's School of Medicine. During this time, Lisa was involved in general diabetes education, pump therapy training and diabetes management during pregnancy. Since 2006, Lisa has been at the Vermont Children's Hospital of Fletcher Allen Healthcare. She is with the pediatric endocrinology team where she specializes in diabetes education, pump therapy and continuous-glucose monitoring. She has lectured extensively on diabetes.
Lisa's daughter Ellie has type 1 diabetes.
Recent Responses
My son is 10 years old (5th grade), diagnosed in August 08. Lately he has missed some school due to illness and keytones. How much school work is he expected to make up? It just keeps piling up, we never seem to get caught up!
Dealing with illnesses in a child with diabetes can be more difficult than not given the potential for high blood glucose levels and/or ketones. And, as you mentioned, it can mean more missed days from school. However, although it is ultimately the teacher and school's decision, I think that he should make up all of the school work missed, just as any other child would be expected to do. Unfortunately, diabetes is too often used as a get-out-of jail free card, and we need to be very careful about sending this message.
We are about 19 months into diabetes life, and we see that her insulin requirements are steadily increasing. Just how much insulin is she going to need when her pancreas completely stops making its own. She is currently on about 25 units for morning needle, and about 7 in the evening...this has doubled since last fall. We are just wondering what she may "top out" at...as it already seems like such a lot. I guess I don't understand enough about the progression of this condition....what "changes" can we expect in the next few years even.
Kudos to you for having such a positive attitude! As you know, there are always ups and downs with diabetes (on so many levels!) but staying positive makes such a difference for everyone, espcially Ariel.To answer your question...there really is no answer! There is no way to know how much insulin someone will need in the future. I am not surprised that her needs are increasing. This is typical the further away you get from date of diagnosis (ie, honeymoon is ending) as well as the more you grow, and in the case of a child, this is a lot! Hormones raise blood glucose levels, which is why growth causes the need for more insulin, as does menstruation (for some women) and pregnancy. Often (though not always) after an increase is made, it may eventually come back down. For example, during puberty insulin requirements can increase dramatically, then they may come down later once puberty has ended.
So again, the simple answer is that there is no way to predict how much insulin Ariel will need as she grows, other than to say it will likely be more than it is now! The bottom line, as always, is that we area looking for as good blood sugar control as possible
