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Question:

From Ohio, USA:

My 21 year old son has had type 1 since the age of 18 months, back in the days when moms had to squeeze urine out of diapers to try to guess at blood sugar levels. He had an otherwise normal life, but his A1c's were high until he became old enough to work with his diabetes.

I certainly do not want to alarm any of the parents with infants, so please keep in mind that we started dealing with diabetes back in the dark ages -- before blood glucose testing, pumps, and human insulins. Now our son's A1c levels are always in the 6% range. He was diagnosed with stage one kidney disease a year ago. Or at least, that is what I think it is. He is spilling a little microalbumin in his urine.

Individually and as a family, we survived the shock and feelings of grief. However, we don't understand what this means in terms of life expectancy and quality of life. We are blessed, because his last visit to the ophthalmologist revealed no eye problems.

I would like to add some encouragement for the moms (dads, too) of children diagnosed as infants. I cannot relate to doing home blood glucose tests on a young child However, I learned that children are much more resilient than parents. I say that definitively, because I counseled moms of infants, organized a play group when they were toddlers, and organized and ran four parent support groups for JDF for awhile.

Insulin reactions are indeed a concern, and I would never minimize them. However, some of my best memories of my son's childhood are the escapades that he and the other neighborhood children got involved in when they roamed around the neighborhood. Of course, he carried glucose tablets. Many of my gray hairs are from that decision, but now that I am an empty-nester, none of it matters. I am able to enjoy the memories of his joy.

I don't know if any of this will get printed, but if it does, I would like to say one more thing: Please don't let the rigors of life, spousehood, parenting, and treating diabetes keep you so busy that you do not spend at least 30 minutes a week playing at something you like by yourself or with a friend. And when you get back to parenting the child with diabetes, you might want to remember that sex education and alcohol/drug education are important, too. I feel like a bossy old lady, but also please remember, Dad and Mom, that you need time with each other alone. I know it's hard to find babysitter you trust. But going out does help parents want to stay in.

Answer:

From what I understand, your son has microalbuminuria, or a small increase of protein in the urine. At this stage, kidney function is normal. First of all, I assume that your son has either had an overnight urine collection of first morning collection on a day that he has not had vigorous exercise the day before. Many teenagers and young adults, who don't have diabetes or any kidney problems, can have some protein in their urine during the day especially with exercise. His physician may want to start him on an ACE inhibitor (even if his blood pressure is normal) to help prevent progression to overt kidney problems. It is very rare to have significant kidney problems without first having some eye problems, so it sounds like your son's chances of not developing significant kidney problems are still quite excellent.

Good luck and it sounds like you have a wonderful attitude towards your son and his diabetes.

TGL

Additional comments from Craig Broadhurst:

I totally agree with the writer of this post. Parents must "date" occasionally to have an identity beyond "parents of a diabetic child"!

CMB

DTQ-19991013224349
Original posting 16 Sep 2000
Posted to Complications and Daily Care

  
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Last Updated: Tuesday April 06, 2010 15:09:14
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