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Question:

I have a 12-year-old African American son who is Type 1. Are there any studies that address his age and or his ethnic origin? He is gifted athleticalss his age and or his ethnic origin? He is gifted athletically and we have trouble with overnight lows because of his high level of physical activity. Do you have any information or suggestions?

Answer:

The incidence of Type 1 diabetes is considerably less in African Americans than in children of Caucasian descent. Rather interestingly, it has quite recently been shown that just over half of the new onset cases of supposedly Type 1 Diabetes in African Americans are antibody-negative. This is also true in the Hispanic population. This rather suggests that these children do not have a disorder of the immune system; but some other reason for their insulin insufficiency. At the moment the exact nature of the problem is not understood, nor is it known what difference, if any, this makes to treatment or to long-term complications; but it is being investigated energetically.

The problem of low blood sugars at night after vigorous exercise is a common one; but without more information on his insulin dose and the time of day of his athletics, it's not possible to give specific advice. At all events, prevention is a matter of reducing insulin coverage over the period in which he gets hypoglycemic or of appropriately increasing food intake on the days when he has a lot of activity. Probably this will involve decreasing the evening regular insulin or possible switching to the shorter acting lispro insulin [Humalog®] at this time. You need to go over this with his doctor and the team nutritionist. In the meantime if his blood sugar before his bedtime snack is less than 120 mg/dl you should add milk or other food to a solid protein and carbohydrate snack. If the blood sugar is less than 70 mg/dl at this time the test should be repeated at 2 A.M.

DO'B

Original posting 18 May 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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