My 15 month old son was diagnosed at eight months of age, and now he seems to be constantly ill which makes the job of controlling his blood sugar levels that much more difficult. Is he more prone to illness because of the diabetes? Since his blood sugar level is so erratic when he is ill, what are the chances of him developing complications? Our pediatric endocrinologist said infants tend to be more resilient with erratic blood sugar levels. In your experience has this been true?

Your small son’s story is rather common even but is becoming rarer and rarer as most, if not all, the pediatric diabetologists have adopted the basic principles of intensified insulin treatment in this age group of small children. It based on multiple shots of analogs of fast-acting insulins (Humalog and NovoLog) before each meal and Lantus (insulin glargine) (or NPH even though it’s less efficacious) as basal at dinner or bedtime. This is to me the best answer to your doubt.

I would suspect that by adopting this type of insulin regimen, you will see that most of your son’s symptoms will disappear and all the complications will be prevented.

It used to be believed that the years before puberty were not significant when it came to the risk of developing complications. However, it has been clearly shown that 10 or 20 years of diabetes in someone contracting the disease before puberty carries the same risk for eye complications as 10 or 20 years for a person contracting diabetes after puberty. To that end, the hemoglobin A1c should be stabilized at a level not above 6.5%. All this is very feasible nowadays provided your son is cared for by a diabetes team involved in the care of children with type 1 diabetes.

MS