My son was diagnosed with Type 1 diabetes at age 18 months and is just about 2 years old. His blood sugar readings have been up and down meaning sometimes 600 to 50 in a day. Will this ever level out? I am starting to get worried about the dangers of harm to his organs.

I appreciate your frustration. Indeed, caring for a 2 year old with diabetes is a difficult job for parents (and physicians!). Frequently, at that age, the key to managing diabetes is to prevent dangerous lows and treat highs quickly with rapid acting insulin (Humalog or Regular insulin). It is less important at this age to concentrate on aggressively managing diabetes to keep blood sugars in a specified low range as we do with older children and adolescents. You must be in frequent contact with your diabetes team to adjust insulin dosages. In addition, it is important to monitor the amount of food and adjust the rapid acting insulin to cover the amount of carbohydrates the child is eating.

It is unlikely that fluctuations in blood sugars at this age will do longstanding damage to any organs. It is important to work on aggressive control of blood sugars when your child has grown and matured some.

Diabetes never becomes “easy” to manage, but it does become less difficult to manage as your child grows — at least until they become an adolescent.

MSB