I am the stepmother of a four year old with type 1 diabetes, diagnosed at age two. She lives with her mother. Her blood sugar goes from 32 mg/dl [1.8 mmol/L] to over 400 mg/dl [22.2 mmol/L] During the last 10 months, her mother has dropped her blood sugar below 70 mg/dl [3.9 mmol/L] over 85 times (at least three times a week). How many lows are okay? What complications will all these lows cause? We have heard that a lot of lows can cause learning problems. Can this happen?

It is true that frequent low readings in young children can lead to problems with intellect, as described in a study in the 1980s. However, there are no data regarding how often and how frequent these low readings need to occur for learning problems to develop. Also, I don’t think anyone knows if lows for short periods of time and mild lows are associated with any problems.

In children younger than five years, the best thing to do is not to aim for perfect control as that is extremely difficult in a young child do to their unpredictable lifestyle. Aiming for steady readings I think is as important, but don’t be too obsessed with tight control.

JS