My 4 year old son was diagnosed with type 1 eight months ago. We are constantly making adjustments to his insulin regimen. His daily blood glucose can easily swing from 40 to the 500’s. What are the effects of these swings on him and what can be done to help reduce them?

Although it seems clear that the better you can control the blood sugar, the less the risk of long term complications of eyes, kidneys, and nerves, no one really knows how good the control needs to be to protect you against these complications. There is some data to suggest that prior to puberty, the risk of high blood sugars may be less than after puberty.

What is clear is that some children are harder to control than others and may have wide swings in blood sugars. Frequent, serious low blood sugars should be avoided at this age. Only close collaboration with your child’s team can help you decide which is the best approach to control for your child. Sometimes you have to try several different insulin regimens before deciding which is the best.

TGL