My daughter, age 9, was diagnosed with diabetes 3 months ago. Our pediatrician tells me that she is doing "really well for a newly diagnosed child." What range is considered "good control" for a young child? I read somewhere that 75% of the readings should be below 200 - is that a standard yardstick? I worry whenever she tests over 150 - but then I hear others say it's okay as long as it's only one reading. I'd really appreciate hearing if there are any guidelines for children. Thank you.
This is a very good question and one which perplexes all parents of a newly diagnosed child. They are bombarded with information about blood sugars, glycohaemoglobin tests and the effect of sugars on the short term and long term health of their children. No wonder they are confused.
It perhaps helps to break the answer down into several parts.
In the first few weeks of diabetes the main aim is to restore the health and joie de vivre of the child. This means getting the sugars back to levels where the symptoms disappear. In other words the overdrinking and constantly going to the toilet should stop. In addition you don't want to have recurrent or severe hypoglycaemic episodes. In blood sugar terms, I usually suggest to my patients that I want to see 80% of their tests in the 4-10 mmol/L (72 - 180 mg/dl) range within a couple of weeks of diagnosis. The odd high result is inevitable and must be regarded as harmless if parents are not to become nervous wrecks.
Good control may be defined by your clinic in terms of a range for the glycohaemoglobin tests (HbA1c). However, this is specific to each centre and it is dangerous (and quite wrong) to try to compare values from different centres without knowing a lot more about the way they do the tests. Ask your diabetes team what you should be aiming for. The answer they give should be related back to the Diabetes Control and Complications Trial which showed that good blood sugar control over many years, reduces the likelihood of diabetes complications. However, the DCCT did not include any children under 13 years of age so interpretation has to made with care.
I have spent a lot of space saying that there are a number of ways to define "good control". Any of these measures have to be seen in the context of a happy, growing, healthy child in a supportive home environment. If you are not sure what you should be aiming for, speak to your diabetes team and don't worry too much about what others may say or what you read in books.
Original posting 10 Jul 96
Last Updated: Tuesday April 06, 2010 15:08:50
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