My 13-year-old niece was diagnosed with type 1 three years ago. She has always had a problem with constipation, even before being diagnosed. Lately, I have read a lot of information that claims clearing up constipation can help lower glucose levels. Her glucose levels are frequently high, over 200 mg/dl [11.1 mmol/L]. And, her latest A1c was 10.3. The doctor did say we should try and keep the constipation under control but said constipation has nothing to do with her glucose levels. Is there a link between being constipated and high glucose levels? Will keeping her constipation under control help lower her levels?

These blood glucose levels and A1c levels are extremely high and very dangerous. There is a risk of diabetic ketoacidosis and coma as well as long term risks increased for blindness, cataracts, kidney failure, high blood pressure, early heart attack, nerve damage, etc. If the constipation is caused by the nerves to the intestines not being coordinated, this can occur, but is somewhat rare in children and teenagers. So, I would look for other cause of the constipation. Almost all causes in young people are related to amount of fiber intake. Increasing the bran, vegetable and fruit fiber helps about 90% of the time. If not better and this is being done faithfully, then bowel cleanout procedures and tracking with x-rays would let one know this. Supplementing with psyllium, sennokot, Miralax or POEG, mineral oils, or flaxseed all should work. If the bowel continues to retain stool, then consultation with a gastroenterologist is usually required before going to more severe cleanouts such as oil retention enemas and Fleet enemas. The key to all of this is increasing the fluid intake, increasing the fiber intake and documenting what remains in the bowel with sequential x-rays. The only other association with such chronic out-of-control diabetes is the mild dehydration of the body that would go along with so many high sugar levels so often. This usually occurs associated with many missed insulin doses, omitted blood glucose monitoring, inadequate parental supervision and psychosocial problems interfering with appropriate diabetes self-care.

SB