Consider the following reports:
Patient 1.—An 11-year-old boy with a three-year history of insulin-dependent diabetes mellitus was referred to the Children's Diabetes Management Center, Galveston, Tex, for a decreasing insulin dose and marked hypoglycemia with a recent onset of seizures. His metabolic control had always been good, with no episodes of Ketoacidosis; his mother rigidly controlled his insulin administration and food intake. The patient had a two-year history of mild hypoglycemia for which he received carbonated sugar-containing drinks and cake. Because of the increasing frequency of these hypoglycemic episodes, his insulin dosage was decreased from a total of 30 U/d to 8 U/d over the six-month period before admission. During a five-day evaluation, his blood glucose levels increased, as did his insulin requirements (0.8 U/kg/d). His mother continued to be reluctant to allow her son any freedom to manage his disease. Although the child admitted that he had occasionally given
Brouhard BH. Surreptitious Insulin Administration. Am J Dis Child. 1987;141(1):28–29. doi:10.1001/archpedi.1987.04460010028016
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