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Question:

From Australia:

Our 8 year old son was diagnosed with Type 1 diabetes about three months ago. We are interested to know whether any long term damage is sustained during the period leading up to the diagnosis as the body is exposed to extremely high (25+ [450 mg/dl]) blood glucose levels. In addition we are anxious to find out whether an occasional reading of 18+ [324 mg/dl] say three times per week, we think due to the honeymoon phase, poses a major health risk if ketones are not present.

Answer:

A "priming" effect of preclinical hyperglycemia on future microvascular complications has been described in animal models (dogs). This seemed to depend on the length of the preclinical period and therefore the time span body tissues are exposed to very high and sustained levels of blood sugar. In a child as your son this period is generally too short for glucose to exerts its toxic effects.

A better indicator of the chronic hyperglycemia leading to complications is glycohemoglobin levels lasting for years at levels greater than 8% and this probably explains the positive association described so far in epidemiological studies between duration of the disease and long term complications. Recently, the DCCT study provided definitive demonstration of a beneficial effect of good metabolic control on long-term complications in IDDM reducing the development and progression of all complications by approximately 50%.

To sum up, don't worry about short and modest fluctuations of blood sugar, as you mention three times a week, because it's average metabolic control that counts in all diabetic complications.

MS

Original posting 22 Jul 97

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