My three year old son was diagnosed five months ago with type 1 diabetes, and his A1c was 10.4% at the time of diagnosis, but came down to 6.7% after four months. We are worried about the long term complications. With his present condition, how many years can he live without any complications? How long he can live in general? What do the statistics say?

It is not really possible to give even an approximate figure for the likelihood of complications or for life expectancy because the important variables have been changing so rapidly for the better. What has been clear though, is that the single most important factor is the degree to which blood sugars can be kept within the normal or near normal range throughout the 24 hours. This is still not easy in a three year old, especially as you are also trying to avoid hypoglycemia, but judging from your son’s hemoglobin A1c you have started off splendidly.

Nowadays though, new methods of measuring blood sugar on minute forearm blood samples that are almost painless, ultrafine needles, and new insulins and patterns of giving insulin including the use of insulin pumps in very young children are helping with this goal. There are real prospects too that in the not too distant future it will be possible to transplant a variety of surrogate insulin producing cells to which the recipient can be made tolerant with monoclonal antibodies without the need for permanent immunosuppression. All of this still makes big demands on both the child and the parents especially in the early years so it is important to understand that psychosocial issues have to be considered and that help in resolving these may be needed.

DOB