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March 19, 2002

School and Daycare

Question from Ontario, Canada:

My seven year old son is repeating the first grade because he didn't do well last year. However, since his type 1 diabetes (diagnosed about five months ago) is under control, the teacher he has now said that he is doing very well. She also suggested that perhaps he didn't do well last year because of the impending diabetes, but I'm not sure, since he only had the symptoms for about a week before diagnosis. What do you think?

Answer:

That’s hard to say. It sure is tempting to ascribed all “the bad” stuff to diabetes, but I don’t think that is always fair.

In broad terms, in the person with type 1 diabetes, the destruction of the insulin-producing cells was going on for some time before the development of symptomatic diabetes. During that time, even though insulin producing capacity was diminished, the glucose levels themselves were pretty normal. It wasn’t until that very last “straw-that-broke-the-camel’s-back” (when not quite enough insulin could be maintained) that the blood glucose really started to rise and lead to the physiologic changes that lead to increased thirst, urination, etc. That is when your son developed his diabetes, even though he most likely had impaired glucose tolerance for the preceding several months. So I think I agree with you.

DS