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August 28, 2004

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Question from United States:

According to a Swedish study on the Prevention of adverse effects on juvenile diabetes, "practically every day a great majority of children or teenagers with diabetes has subcutaneous glucose concentrations below 2.2mmol/l [40 mg/dl]." It has also been reported that both healthy children and adults may have values below 3 mmol/l [54 mg/dl] without symptoms or signs of hypoglycemia. Based on the data obtained, it has been suggested that "physiological glucose concentration, especially during night, is lower than has previously been thought". Does this imply that when we, parents, see blood sugar readings around 3 mmol/l [54 mg/dl], we should consider such values "normal" without any need for an immediate action?

Answer:

Nope. Treatment with insulin for type 1 diabetes should always be aiming for optimum glucose control and avoidance of significant hypoglycemia. This is defined for the individual based upon hypoglycemia unawareness syndrome, history of convulsions or loss of consciousness, target glucose goals etc. While it is useful to know what “normal” values are vis-a-vis overnight blood glucose readings, this is different from those with diabetes whose blood glucose values fluctuate enormously before and after meals, activity, stress, infections, etc.

SB