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We keep our son in tight control of his diabetes. His last HbA1c was 6.9. Can you tell me the dangers of keeping him in such tight control? Does having BG's that range from 55-90 cause any type of problem? Are we somehow starving his body from something he needs? He is rarely symptomatic (once a week) and it is controled easily by juice. We just want to make sure that tight control is OK or is it better to be between 100-200 and if so why?

The numbers you quote (55-90) may be too low to be realistic for most kids with diabetes. It would depend on your son's age, and his knowledge and ability and willingness to participate in his own care.

At the Children's Diabetes Center at Children's Mercy Hospital, we routinely recommend for most of our older kids to be between 70 and 150 at least 75% of the time; for kids under 7, we usually aim between 100 and 200.

Although we all assume that "tight control" will be of benefit to children, as it has been shown to be in adults with IDDM (see our Commentary on the DCCT), there's very little data that shows this to be the case in subteens. Plus, there's obviously the concern that a severe insulin reaction could occur in anyone aiming for "tight control," and the benefits of "tight control" must be weighed against the risks of reactions, and the psychologic issues that will occur if the child feels "different" from his/her peers.

Be sure that you and your son discuss his targets for blood sugar control, and his response to the program, with his Diabetes Team!

Original posting 14 Dec 95


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Last Updated: Tuesday April 06, 2010 15:08:52
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