Question:
Our son, who has Type 1 diabetes, has been experiencing sporadic high and lows. With close monitoring (6 times a day) we are keeping on top of them, but what we are curious about is whether there is any long term effects by him peaking to 16 or 18 mmol [288 to 324 mg/dl, Ed] for a short period of time (less than 2 hours) or a low of under 4 mmol [72 mg/dl, Ed], again for a short period of time. It had been mentioned that some "intellectual impairment" can occur at the lows, and of course there are the long term (heart, circulation, kidney, etc.) complications associated with the highs.
Answer:
I often tell my patients that it's nothing short of remarkable that we can
control diabetes at all with the tools at our disposal. We give the wrong
stuff into the wrong place in the wrong dose at the wrong time -- and it
still works. Anybody with diabetes will have some higher and some lower
sugars. The skill is to minimise these and there are so many other
variables (especially marked changes in activity) that you are searching
for a Holy Grail. Speak to your diabetes team if your son's sugars are
swinging
wildly up and down because this often indicates too high an insulin dose.
KJR
Original posting 29 Jan 97
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