My four year old daughter was diagnosed at three weeks of age with type�1 diabetes. The long term affects are what have me concerned since her readings run in the 400-500 mg/dl [22.2 – 27.7 mmol/L] range. What are the long term effects on children with diabetes?

The long term effects in children are no different than those for anyone else who develops diabetes. However, it is important to remember that good control helps to prevent complications in the long term. Having said this, it is extremely difficult to get good control in children, especially under five years of age, so we must be realistic and try and aim for the best control possible. If you are having problems keeping reasonable control you should get back to your diabetes team to try and improve things.

JS

[Editor’s comment: I would be curious to know whether or not the blood sugar values you cite are intermittent or routine. It would also be helpful to know what her HbA1c is.

The DCCT demonstrated, clearly, the need for good control to prevent the long-term complications of diabetes. While, as Dr. Schulga has pointed out, it is not unusual for young children to occasionally have values as high as this, I would be concerned if this is a regular pattern. You need to strive for the best possible control without frequent, severe episodes of hypoglycemia, even in a child as young as your daughter, especially since she has always had diabetes.

If your daughter is not currently being followed by a diabetes team specializing in the care of children, I would suggest that you find one. If there is not such a program nearby, it would be well worth your while to visit one at least once a year. A pediatric diabetes team will be able to assist you in finding the right treatment program to optimize control and prevent long-term complications.

SS]