What else should I do?

[1Concerned]

My nephew has a six year old son who was diagnosed with Type 1 diabetes about a year ago. He weighs 40 lbs, extremely thin. I have observed on more than one occasion where he is allowed to eat the wrong things. His glucose level last night when checked after dinner was 600+. This is not unusual however, it is always running between 500 and 600. Last night he drank two 16 oz bottles of water in less than two hours. My nephew after checking his glucose level gave him his insulin shot. Then he drank another 16 oz bottle of water. About an hour later, the six year old said that he was hungry and could he have some macaroni and cheese. My nephew gave him a serving of macaroni and cheese that was enough for two people, and to make matters worse he also added a roll with it. He only gave him about an ounce of greens. I told my nephew that he was giving his son wrong things to eat but he told me that he was trying to put some weight on him because he was too thin. I am totally upset because I am concerned that the glucose level on this 40 lb six year old is way too high. What should I do??!!

[JDRF-VOL-RL]

Hello, you are right to be concerned.  I'm not a medical professional, just the parent of a kid with diabetes.  Your nephew's scores are so high, and have been so high for so long, that he's likely experiencing diabetic ketoacidosis.  That is the reason he is so thin, because his body isn't getting enough insulin, causing it to consume itself in order to survive.  This is a VERY deadly condition.  I can't stress that enough, that the child's life is in danger because his insulin doses are too low.  Eating those things aren't necessarily a bad thing by itself, as long as the proper insulin is given to cover the carbs.  That obviously isn't happening.  As a parent of a kid with diabetes, I would recommend that this child needs to be taken to the emergency room immediately, and the parents be given more education for how to count carbs and how to dose insulin properly to cover the carbs.  Your nephew needs to be seen by a doctor immediately, and he will likely require hospitalization in order to recover.  That glucose level is far too high for anyone, much less a 6 year old.  Good luck.

[JDRF-VOL-RL]

Whoops, saw I messed up, and it's your nephew's son with diabetes and not your nephew.  Regardless, the boy needs to be taken to an emergency room as soon as possible.

[JDRF-VOL-SG]

I totally agree -- ketoacidosis can kill. Diabetics who are not under control DO lose weight, and no matter how much he eats, he is going to continue to lose weight while the body consumes its own fat cells because there is not enough insulin present to convert the carbs he eats to energy. The body goes after fat stores in desperation for energy. The child is also likely to feel awful, to be tired, and to be a walking magnet for bacterial and viral infections until his glucose levels are brought under control.

Yes, he CAN eat macaroni and cheese and rolls, but he needs to be taking the proper amount of insulin to cover them. And it is apparent from levels that high that his dosage is not right. It could be that the dose was correct when he was first diagnosed, but that he needs more insulin now. If your nephew refuses to go to the emergency room, he absolutely must at least get a next-day appointment with his doctor. But I agree that the emergency room is the better option, for he will have to end up in the hospital either way for lab tests, and he will get a quicker response in the emergency room. This truly is a life-threatening situation. People can go into comas and die or suffer kidney failure that is ireversable when in ketoacidosis too long.

[astro125]

Also, from 500-600 is not a normal range, he could go blind form having such high levels, i would suggest getting his A1C checked at his doctor as soon as possible