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October 4, 2001

Complications

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Question from Santo Domingo, Dominican Republic:

My five year old son was diagnosed with type�1 diabetes about 20 months ago, and his doctor tells me that every glucose above 180 mg/dl [10 mmol/L], always sends sugar to the urine. I interpret this to mean it passes through the kidneys, and if this is so, I’m very worried, because my son is higher than that after every meal. How badly does this sugar in his urine (every day) affect his kidneys?

Answer:

I want to reassure you that it’s not so bad if the glucosuria is of short duration and if your son’s hemoglobin A1c is in target range. In order to decrease the spilling of sugar into the urine, I suggest that you might take greater care in timing the before meal injections of insulin to coincide with the peak after meal blood glucose levels. Secondly, different types of food might be also responsible (the so-called glycemic index) for the transient peaks after the meals. Ask your son’s diabetes team for further dietary advice.

MS