November 13, 2002
Complications
Question from Whitby, Ontario, Canada:
This past year, my six year old son, who has had type 1 diabetes for three years, has developed necrobiosis just above the ankle and above his belly button, and, from what we are told, this does not happen to children. The specialists are and his endocrinologist are all stumped on how this could have happened and the side effects it could lead to. It is not from their lack of trying, but when they do not have answers, it really worries my wife and I. We are concerned about long term effects this can have on him (e.g., playing and hurting his ankle, or cutting it). Any information you can provide would really help!
Answer:
It’s very rare to see necrobiosis these days, but it occasionally happens — even in very young children. You did not mention his glucose control, but the more this can be “tightened,” perhaps the more healing will be possible.
You also did not mention any treatment, but sometimes a small dose of aspirin (81 mg per day) helps decrease inflammation and may “open” up these clogged arterioles that contribute/lead to necrobiosis. You should go back and work with your diabetes team to set up a way to protect the damaged skin and maximize glucose control, of course.
SB
