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April 4, 2000

Tight Control

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Question from Chicago, Illinois, USA:

My 4 1/2 year old son was diagnosed 2 months ago and has been doing well in his honeymoon stage. He currently takes NPH only; 6u in the A.M. and 4u in the P.M. His glucose level is between 70-120 with occasional dips to the 50s but has no symptoms. I have read a great deal about tight control and am happy with our success. I read several items though suggesting that low blood sugars may cause motor and learning delays in developing children. Do you have any info and do you believe these levels are adequate?

Answer:

From: DTeam Staff

I agree with all your statements

Control does matter
Hypos do matter too

Balance is the issue:

We tend to forget that the Diabetes Control and Complications Trial (DCCT) only reduced average glucoses to the 150 level. Parents sometimes try to make the glucose “normal”. If it were normal the child wouldn’t have diabetes.

I would advise a family to avoid the 50’s and back off just a bit.

LD
Additional comments from Lois Schmidt Finney, diabetes dietitian:

At our program, we do not recommend such tight control for young children since hypoglycemia may be detrimental to learning and coordination skills. Also, for those who run habitual low blood glucoses, they may lose the ability to have symptoms of low blood glucoses. We used to think it only happened after at least 10 years of diabetes, but this is often not the case in children.

LSF