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April 17, 2001


Question from St. Louis, Missouri, USA:

My five year old son, who has had diabetes since age two and a half, has been on an insulin pump for over a year and is doing very well. Recently, I read something about diabetic autonomic neuropathy being detectable and treatable (reversible). Are you familiar with "heart rate variability testing"? The article I read says that it is very rarely tested for. At what age do you think diabetics typically show signs of diabetic autonomic neuropathy? Is it realistic for me to ask to have my five year old be tested?


No! That said, we really have no data on children except to tell parents they don’t have heart disease. That really is true. In my more than 25 years of experience, I don’t have any data save watching my share grow to be adults with no heart disease. When to test? I would expect in the mid-twenties to thirty at the soonest.