Novolog antibodies and moderate ketones

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lorihaapala Posted: Wed, Feb 16 2011 8:35 PM

My son is now 13 and was diagnosed 7 years ago.  He has been pumping for the last 6 years.  He has always had pretty good control until the last 6 months.  His A1C is a point higher and he keeps requiring more and more insulin.  

I know that during puberty kids can use a lot more insulin.  It's just the past 3 weeks he has been producing small to moderate ketones with normal blood sugars and no illness.  He has only had ketones in the past when he was really sick with strep or a virus.  

His blood sugar will be normal and he will still have ketones and bad headaches.  Our endo suggested he may be "allergic" to the Novolog and may be producing antibodies to the Novolog.  The insulin autoantibody test came back high at 45.  However, the endo says to have be producing antibodies that show you shouldn't use the insulin anymore the numbers  should be over 400.  Has anyone experienced anything like this?  

Thanks so much !!

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Debbie replied on Fri, Feb 18 2011 6:39 AM

I spoke to a pediatric endocrinologist about your questions.  He said that true insulin allergies are very rare.  He also said that you may want to talk to your son’s health care team about your son going off the pump temporarily and trying a brief trial of injections with long-acting insulin (Lantus or Levemir) and Novolog to see if that clears the ketones--which would also address the allergy question.

 

Good luck!

 

-Debbie Butler, LICSW, CDE

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