If Treatment Stops Working
Reviewed by CDE Mehandi Sharma · Updated
At some point your child's readings will start drifting upward on treatment that was working. This is common, and it almost always has a findable reason.
The most likely one is simply growth. A dose is set for a body of a certain size, and children outgrow doses continuously. This is why doses in childhood are reviewed so often, and why a period of rapid growth usually needs an adjustment.
Other explanations worth working through:
- Illness or infection, which raises blood sugar temporarily.
- Insulin that has been damaged by heat — a common and easily missed cause in Indian summers.
- A change in feeding, especially starting solids or a growth spurt in appetite.
- Injection sites used repeatedly in one spot, which absorb unpredictably.
- A suspension prepared differently, or a dose being spat out more often than you realised.
If none of those explains it, your team may look for another condition. Coeliac disease and thyroid problems both occur more often in children with diabetes and both can unsettle control — among Indian children with diabetes, coeliac disease has been found in around 11%, and thyroid problems are also common.
In children on tablets, a genuine loss of response is uncommon — in a ten-year follow-up, 93% were still controlled on the tablet alone. So drifting control is much more likely to be dose, growth or another condition than the medicine failing.
Bring your logs rather than a summary. The pattern of when it drifts is usually what identifies the cause.