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January 23, 2002

Complications

Question from Port Orchard, Washington, USA:

My 15 year old niece was just diagnosed with type 1 diabetes two days ago. Her initial blood sugar level was 2400 mg/dl [133.3 mmol/L], but she fortunately did not go into a coma. After two days, it went down to 220 mg/dl [12.2 mmol/L]. She is also still experiencing blurred vision. Is it common to have vision problems after the levels have come that far down?

Answer:

The blurred vision most likely reflects swelling (edema) to the lenses of the eyes since, as glucose goes up — with increased glucose into the lens — water will follow, causing the lens to swell. As the glucose leaves, the water leaves, causing the lens to shrink. These dramatic changes in these first weeks of diagnosis can cause vision changes. For this reason, I generally do not recommend a fitting for glasses right now, as the visual acuity and any near or far-sightedness may change.

DS