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Tight Control

I was very concerned about what I read in the article entitled Conventional Versus Intensive Diabetes Therapy in Children with Type 1 Diabetes. Could you please explain what is meant by “Intensive Therapy”? Is this maintaining “tight control”?

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My son, 11 years old, type 1 diabetes for four years, has had over 600 hypoglycaemic episodes. He also has frequent episodes of hyperglycaemia. He has had tests on hypothalmus, adrenal glands, pituitary gland and pancreas. Our specialist Professor is finding it difficult to come up with answers as to why his condition is so fragile. Have you encountered this before?

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My seven year old son, diagnosed at age four, has good, but not tight, control on a two shot per day regimen. His highest A1c reading to date has been 7.2%. At what age does “tight” — rather than just “good” — control become imperative for children with diabetes?

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I am 16 years old and my last three hemoglobin A1c tests were 6.4, 6.1, and 6.7%, but I have been getting some blood sugars in the high 200s mg/dl [11.1 mmol/L] and a few in the low 300s mg/dl [16.7 mmol/L]. Can you please tell me if my hemoglobin A1c tests are okay and what I need to do to prevent complications and lead a full and healthy life?

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I am a paediatric diabetes nurse who is wondering what you would advocate as a safe HbA1c range for younger children with type 1 diabetes.

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Are there any ongoing studies that look at people who have had diabetes for more than 15 years with A1cs in the normal range for that period for time? What do you think the complication rates would be for normalization around the clock, with a few highs but corrected shortly after?

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My 20 year girlfriend has type 1 diabetes and uses an insulin pump. If her sugar levels remain under control, will she still develop the complications later on in life?

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I have had type 1 diabetes for the last 6 years. I take three injections a day, pre-breakfast, pre-lunch and pre-dinner. My 3 am blood sugars drop down to 40 mg/dl [2.2 mmol/L] or so, and my pre-breakfast readings are 200-250 mg/dl [11.1-13.9 mmol/L]. Please guide.

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I have had type 1 diabetes for 15 years today and cannot say that I have taken extremely good care of myself for a few years. I am 29 now and am realizing the limitations of mortality, etc. Essentially, I want to see my children grow old and am worried. It sure pays to monitor I realize now. What can I expect my life expectancy to be at this rate?

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I have had type 1 diabetes for 21 years. Why three months ago did I have a leaky blood vessel in my eye when, for the past five years, my A1c’s have all been under 7.2%?

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