Need Quick Response!!

[MrsBadshoe]

The newly DX korean high school student at my dd's school....never given much if any education prior to leaving hospital...

They don't test her prior to gym
She walked across campus with a low to get juice.
She has no idea what Ketones are or that you need to test for them..
They have not gotten her an medical ID

Scarest part and what I really need info on....She is DX 10 days ago and she is taking 32 units of novolog a day and 26 units of lantus. She does not change the dose based on anything she eats... 12 units- breakfast, 10 units lunch, 10 units dinner...

She weighs maybe 100 lbs...

Does anybody feel this is as dangerous as we do????I 'm scared to death for this kid...

[Kaylee's Mommy]

WOW, that just sounds crazy.. not sure how you'd go about getting her some better info.. is she an exchange student? do you know her parents (if she's not an exchange student) maybe you could 'reach' out to them.. let them know that you are there if they need anything.. she should definitely be carring some kind of quick acting sugar on her.. what hospital did she go to? I don't understand why they would release someone and not give them the information they need to control their diabetes..

I feel for the poor girl.. she has no idea!:(

[selketine]

That does not sound good at all.

Who is responsible for her care at this point? (her mom is here? the director of the school? a pastor?)

Can she do some of it herself?

Is she supposed to eat a set # of carbs per meal with no snacks so as to make the insulin dose right?

Is she supposed to go back for more education?

Perhaps she is caught between our medical system and being away from home and the support isn't so great. It seems to me that she should go home so her family can help her with this but I take it that is problematic too? No way in heck I'd let my kid stay in a foreign country after this kind of diagnosis.

[BrendaK]

Holy Cow, that's alot of insulin. My mom who is probably 115 pounds, takes 16 units of Lantus and maybe 12 units or so of Humalog a day. TDD 28-30 units.

Who is in charge of her medical care while she's here. I hope you can be an advocate for her!!

[Momof4gr8kids]

Yes! I do! Is there anything you guys can do to help her, and her family, or the school, or whoever is her gardian get some education?

[MrsBadshoe]

She is a dorm student. Family in Korea...father speaks broken English.

We tried to get them to let us have her live here until the end of the school year...but due to the fact that the school is considerd her temporary legal guardians they wouldn't let us house her temporarily even with the parents consent.

The school nurse is responsible for her care but as far as I can tell doesn't have a clear understanding of what is involved or the dangers that improper care might cause.

I was scared by the not knowing about ketones, making her walk across campus with a low and exercising without testing

But I'm scared to death with the fact that she is taking 58 units of insulin and not making sure she covers the carbs....

Our nurse said you are usually insulin resistant at first which makes me think why she has made it this far without a problem...but I'm terrified for this kid.

[Noel]

Oh my....yes that is a lot of insulin!!! I wish I had a suggestion for you but I don't....sounds like you are trying to help!! Keep trying...don't give up you may be her only chance at getting things under control...

Is there some place that you can maybe find a translator, someone who is fluent in both Korean and English? Having someone like this relay info from you to her parent may help them understand better what is going on...

I also think that where ever she was diagnosed needs to be in touch with the nurse on campus and give her some further education.

I'm scared for her....please keep us posted!

[Q's mama]

maybe the local diabetes association or a cde could be helpful...would the school be open to getting someone to come in to do a presentation...at least to learn the basics?
What a scary situation! I am praying for this girl.

[Kaylee's Mommy]

can you go to the school nurse and let her know that you are really concerned that she is on way to much insulin?

maybe they would let her stay a weekend with you so you could try and get her to understand whats going on?

[liasmommy2000]

Oh goodness, that sounds like a very scary situation to me.

I can't think of anything off hand, but good luck helping her. Poor girl! Maybe you can get into contact with some Korean-American groups in the area to see if they could be any help with the language issue, helping her get assistance etc?

[Ali]

Is there any way to check with the Dr./hospital and make sure the insulin doses were recorded accurately-mistakes happen. Is she testing at all? You may need to see if she can get in to see an endo with a translator to work through what she should be doing and then make sure everything is written in both English and Korean for her and the school.You could work with a translator to get her parents to tell the school to send her to an endo with you and a translator along for back up. Good luck. Ali

[Adinsmom]

I can just imagine how scared the student and her family are. :( Being newly diagnosed is overwhelming under the best of circumstances. Is there anyway you can contact the superintendant of the school and let him/her know how dangerous the situation is? She needs proper D supervision. Can you contact her doctor? I would think the ADA in your area could help you find a translator and could come up with something.

God Bless you and your family for being her advocate. I will say a prayer. Please keep us informed.

[MrsBadshoe]

Thanks for all your comments. I just wanted to confirm I wasn't crazy about the amount of insulin that they are injecting.

[hold48398]

Wow how very VERY scary. I was an international student when I came to this country, and two places helped me sort things out: the International Student office on my college campus and the Swiss Embassy.

I dont know if the Korean embassy could help but it might be worth a shot.

[Tamara Gamble]

Seems like an awful lot and extremely freightening. As far as the NovoLog goes they may have them giving a certain amount of carbs at each meal and for snack. Perhapse with the language barrier the doctor felt that a set number was best for the time being instead of doing the calculations. They did this for Ty in the beggining. I am wondering if her diet is very high in carbs. I'm not trying to be rude in any way. But my aunt is from Thailand and she and my uncle eat alot of rice with their meals. The Lantus is nuts to though so this wouldn't explain that. I know that when Ty was first diagnosed he was on 12 u lantus a day. Now it would be about 18 u if his pump was broken at about a 50/50 ratio. He is twelve and lean. Could it be due to menstral issues? I'm sorry, I missed the age. Our nurse told us that through her teen years she was on triple the insulin she is now. I would see if you could double check with doc on the numbers. This would scare me too.

[MrsBadshoe]

Is there any way to check with the Dr./hospital and make sure the insulin doses were recorded accurately-mistakes happen. Is she testing at all? You may need to see if she can get in to see an endo with a translator to work through what she should be doing and then make sure everything is written in both English and Korean for her and the school.You could work with a translator to get her parents to tell the school to send her to an endo with you and a translator along for back up. Good luck. Ali


We have no HIPPA standing so we can't talk with the endo. She does test prior to meals and before bed.

I can just imagine how scared the student and her family are. Being newly diagnosed is overwhelming under the best of circumstances. Is there anyway you can contact the superintendant of the school and let him/her know how dangerous the situation is? She needs proper D supervision. Can you contact her doctor? I would think the ADA in your area could help you find a translator and could come up with something.

She isn't scared cause she has no idea what that much insulin means. I called the principal prior to finding out the amount of inulsin injecting and she can meet with me on Monday afternoon.

Seems like an awful lot and extremely freightening. As far as the NovoLog goes they may have them giving a certain amount of carbs at each meal and for snack. Perhapse with the language barrier the doctor felt that a set number was best for the time being instead of doing the calculations. They did this for Ty in the beggining. I am wondering if her diet is very high in carbs. I'm not trying to be rude in any way. But my aunt is from Thailand and she and my uncle eat alot of rice with their meals. The Lantus is nuts to though so this wouldn't explain that. I know that when Ty was first diagnosed he was on 12 u lantus a day. Now it would be about 18 u if his pump was broken at about a 50/50 ratio. He is twelve and lean. Could it be due to menstral issues? I'm sorry, I missed the age. Our nurse told us that through her teen years she was on triple the insulin she is now. I would see if you could double check with doc on the numbers. This would scare me too.

Only problem with the set carbs theory is she ate dinner here tonight and never tried to figure out how many carbs she was eating. I did make sure she had extra rice because I was terrified.

She is 17 I think. Maybe that is the answer about puberty.

[megan'smom]

That is absolutely crazy!!! Is there anyway a translator can be found? Maybe the Endo or management team can suggest something?!? This is very frightening...as for the school nurse, most of them are not thoroghly educated. This is exactly why I'm changing careers, so I can be near my children during school hours...most people just don't understand the impact that too much (or too little) insulin can have. There must be something that can be done...Good Luck to you.

[Ali]

When I was a teen my insulin needs were not any greater than as an adult. My need does change due to hormones but that is not universally true for females. If her parents give you an OK to go with her to a Dr. I would be surprised if the Dr. did not let you in-not to ask for the records but to go with her, I accompany people all the time to their Dr. appts. Good Luck.

[Mama Belle]

That is an insane amount of insulin. My Dad who weighs twice what she does doesn't even take that much insulin in a day.

I would speak with school administration about this and air your concerns. If they go unanswered I would see if you can find a way to ask the ADA or social services to aid as an advocate in an advisory role. There is a very real danger of her dropping into a very dangerous low. This is complicated by the fact that she has no medical identification at all. Can you give her a generic Medical ID bracelet (like one from the drug store or something) indicating Diabetes, until she can get one of her own? I can't believe the dangerous situation this child has been thrown into. :(

[lilituc]

It's actually not uncommon to need a surprisingly large dose of insulin when first diagnosed. Once things settle down, then she should drop down to a dose you would expect. I wouldn't worry about if a doctor is following her situation.

Not testing, though - that's crazy.

[deafmack]

I think there must be a language problem here. Maybe you could ask what kind of training she has had. Obviously she is not getting the care she needs. That is a lot of insulin and the only reason I can think of is there is something going on like insulin resistance. Did she have an interpreter at the hospital when she was diagnosed and told what to do? Just because she goes to college here does not mean she has a good command of English. I would be very concerned about her.

[lilituc]

Just to prove I'm not making this up ;), here's a section from page 54 of Medical Management of Type 1 Diabetes, which is a book published by the ADA as a guide for physicians.

Treatment should begin with ~.6-.75 unit/kg/day. However, during the first week of therapy, this amount can be expected to increase to an average of 1 unit/kg/day, because most patients are relatively insulin resistant at this time. This is particularly true for adolescents.

[MrsBadshoe]

Just to prove I'm not making this up ;), here's a section from page 54 of Medical Management of Type 1 Diabetes, which is a book published by the ADA as a guide for physicians.

Treatment should begin with ~.6-.75 unit/kg/day. However, during the first week of therapy, this amount can be expected to increase to an average of 1 unit/kg/day, because most patients are relatively insulin resistant at this time. This is particularly true for adolescents.


I agree with this but my fear falls into the place that she isn't counting carbs at all. She has a set amount of insulin prescribed. 12 log breakfast, 10 log lunch, 10 log dinner and 26 units lantus.

I'm not sure if they are in daily contact with a endo because I'm not allowed to know that info. Yet, all the items the bothered me prior to last night we clear indications that they don't know what they are doing.

[Ivan's Mum]

Many Korean families are strongly involved in their faith of choice. Might be an idea to find out where she goes to church (if she does) and talk to the church. They will probably talk to the family on your behalf and make sure it doesn't get lost in translation.

If the exchange/international student is run through an agency as such, make contact with them. She should probably have medical insurance so you may have some luck finding a korean doctor who will talk to her, even if they're not an endo.

She's very lucky to have someone like you looking out for her.

Plus, she should be able to look up information on T1, in korean on the net. It might be a case of she needs to inform herself.

[KatelinsMom]

My daughter is 15. She is on 34 units of lantus at bedtime and takes on average about 23 units of Novolog daily, but she weighs more than 100 pounds..probably closer to 135-140 pounds.

The lantus dose for the Korean girl sounds okay, just in comparing to what my daughter is taking (but then again, what do I know). The Novolog really should be based on what she is eating though. I would be more worried about the Novolog and carb amounts she is getting, also that she walked across campus when low to get a juice..:eek: Gosh, I sure hope she gets some help.

[MrsBadshoe]

Many Korean families are strongly involved in their faith of choice. Might be an idea to find out where she goes to church (if she does) and talk to the church. They will probably talk to the family on your behalf and make sure it doesn't get lost in translation.

If the exchange/international student is run through an agency as such, make contact with them. She should probably have medical insurance so you may have some luck finding a korean doctor who will talk to her, even if they're not an endo.

She's very lucky to have someone like you looking out for her.

Plus, she should be able to look up information on T1, in korean on the net. It might be a case of she needs to inform herself.

The local korean pastor of our church which recruits the korean students to come to our high school because it is religioius and has boarding...is usless...he is following the lead of the principal.

[MrsBadshoe]

My daughter is 15. She is on 34 units of lantus at bedtime and takes on average about 23 units of Novolog daily, but she weighs more than 100 pounds..probably closer to 135-140 pounds.

The lantus dose for the Korean girl sounds okay, just in comparing to what my daughter is taking (but then again, what do I know). The Novolog really should be based on what she is eating though. I would be more worried about the Novolog and carb amounts she is getting, also that she walked across campus when low to get a juice..:eek: Gosh, I sure hope she gets some help.

It is the novolog I am most worried about...she just eats..has no clue as to what carbs are or how much insulin she is giving herself. They haven't been testing her prior gym so they have no idea how her body reacts to exercise. The haven't ever tested her over night so they have no idea how her lantus is behaving after the evening shot.

I spoke with them expressed my worries and concerns...they thanked me for coming and that was it....I have no idea if they will change there ways...but I can always hope..