I am concerned about my four year old nephew who was diagnosed with type 1 diabetes about a year ago. I had gestational diabetes with my last child so I know a little about diabetes. His parents say that they like his sugar to be around 300 mg/dl [16.7 mmol/L], which is pretty high to me. They don’t feed him the right foods like I was on when I had diabetes and mine never got this high. He will have his insulin shot then they will give him his snack which is usually sugar wafer cookies or from a fast food restaurant. He also has seizures that had just started since he was diagnosed with this. I just want to know if it’s really nothing to worry about or if I should have a talk with his parents since they really take in consideration to what I have to say.

Really the most appropriate person(s) to talk to your nephew’s parents are the members of his pediatric diabetes team! Does he have one? If not, I strongly suggest that you urge his parents seek out a consultation with such a diabetes team. If they already see a pediatric diabetes specialist, then perhaps you can accompany them to the next visit. I think it really is helpful when families take on diabetes as a family — and not just “the child’s diabetes.”

While we often will tolerate higher glucose readings in younger children, in order to avoid too many low readings, I think frequent 300 mg/dl [16.7 mmol/L] values are too high. As for snacking, that often depends on the person’s individualized insulin regimen. However, solely based on your description, your nephew’s glucose control does not sound optimal to me. The issues of seizures may be related to hypoglycemia (and widely fluctuating glucose values), but could be something else. I’m glad that you care and that his parents can get your support and input.

DS