My nine year old son, who has had type�1 diabetes for three years, is still no nearer to becoming “stable”. We are still getting regular nighttime hypos and regular daytime highs, but his diabetes team does not seem to know what they are talking about and have never managed to get his diabetes under control. Do you think we ever will? How long does it normally take to settle?

I can understand your troubles and your concern about your son. Controlling the blood sugar levels in a nine year old is a tough challenge and takes some time (not as long as three years though) depending on the partners (the patient with his/her family and the diabetes team). I think you should try harder and sooner to get better metabolic control (as judged as from the hemoglobin A1c). To this aim any regimen based on multiple daily injections is nowadays the best therapeutic approach. Quite recently, insulin pump therapy has spread among youngsters, to stabilize blood sugar levels, but your family would need to have very close contact with a diabetes center comfortable in using the pump with children and adolescents.

Nevertheless, education is, by far, most important in achieving good metabolic control and you look as you still need it. It’s not the diabetes team who must manage someone’s diabetes; it’s the patient with his/her family who must be educated on how to best manage it. To this aim, our website can make the difference through its easy and fast access to news and information regarding diabetes and its management. It can help you keep up-to-date through our answers to various questions and topics.

As your son grows up, he will be gradually able to take more responsibility with self-monitoring and self-management. This will be helpful for better metabolic control. In the meantime, trying to avoid frank hypoglycemia and huge fluctuations of blood sugar levels as very temporary goals.

Last but not least, soon there will be new devices and therapeutic opportunities that will make the lives of children with diabetes easier and safer. I really hope these thoughts reassure you and your lovely family.

MS