November 2, 2001
Behavior
Question from Edina, Minnesota, USA:
Six weeks ago, my four year old daughter was diagnosed with type�1 diabetes, and I have been trying to get information on its cognitive effects. I have conducted a Medline search which yielded somewhat conflicting results indicating that hypo and hyperglycemia can cause problems so I am very concerned, and I am having trouble coming up with a plan that focuses on limiting both.
Right now, my daughter is is in pretty good control, but she has a lot of readings over 240 mg/dl [13.3 mmol/L] readings. If we are too diligent about keeping her under 200 mg/dl [11.1 mmol/L], she has more low readings.
What is your opinion on the relationship between early diagnosis and cognitive impairment? What goal would you be most likely to shoot for? What is considered dangerously high for this age?
Answer:
You are wise to be so proactive. We are uncertain to what degree hyperglycemia interferes with academic/scholastic/cognitive performance, although, as you indicated, there is growing information. However, we are quite certain what hypoglycemia can do. Therefore, I would accept higher readings over lower ones.
My goal for a four year old is most glucose readings between 80-180 mg/dl [4.4-10 mmol/L]. If she is newly diagnosed, she soon will honeymoon, most likely. Glucose values over240 mg/dl [13.3 mmol/L] should be monitored for a pattern, and don’t forget to screen for ketones if the glucose is above this level.
DS
