I just had a conference with my child’s kindergarten teacher who said he was delayed in his cognitive thinking, and I’ve read that diabetes affects this. Is this just when glucose levels are not within range or is this long term effect on thought processes?

We know that prolonged and frequent hypoglycemia can negatively affect learning. There is mixed evidence that hyperglycemia in and of itself may also impair learning. Prolonged poor control is a risk factor for future hypertension, strokes, etc., and of course that’s no good for the brain. There is also mixed evidence that hyperglycemia in and of itself may negatively affect memory skills.

So, try to keep the glucoses in good control without super wide fluctuations. Don’t misunderstand — we know that there always be some fluctuation (until there’s a cure), but we want to minimize it. That’s where multiple daily injections of long-acting plus short-acting insulin at meals or insulin pump therapy may hold the best option.

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DS