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Question:

From Salisbury, North Carolina, USA:

With some of the questions and answers I have read lately, I must say that I am really afraid for my six year old son. When I read the previous question about the five year old who will not live long because of complications. I feel there will not be much hope for my son to have a long life. I thought it took at least 10 years for complications to begin. My son is still honeymooning, but slowly coming out of it. He now takes one and a half units of Lantus and NovoLog to cover meals at a rate of one-half unit for 30 grams of carbohydrates. He just started to cover meals several weeks ago. I am really worry when I read of children so young whose lives are shortened so fast. Is there really hope for our children? Some make and it seems that some do not.

Answer:

There is great reason to hope and be confident nowadays. Remember that many studies requiring ten or twenty or longer years were based upon the years when glucose control goals were much looser. We know from the DCCT that tight control helps avoid complications and reduces risks enormously. Family history suggests that other genetic factors are still important, as would be expected, since the background of whether one has high blood pressure, high lipid levels, heart disease, etc. is somewhat genetically determined as well as determined by the long term levels of glucose control. The DCCT proved not only that better glucose levels improve outcome, but that such improvement lasts for at least seven years after the study is finished, even if the control does not get sustained. If the control is sustained, then it would be reasonable to assume that the long term complications would be even lower still.

The tighter the control and the longer the improved control is sustained, the better the short- and long-term outcome. Eye disease, kidney disease, heart disease, nerve damage, growth, etc. are all reflecting how the glucose is managed. A1c levels are one factor. Day-to-day glucose excursions are another. Family genetic factors are another. So, there is much to be optimistic about using insulin pumps, multi dose insulin regimens, algorithms, carbohydrate counting and all based upon frequent blood glucose monitoring to individualize such treatment. Please go back and discuss this with your diabetes team so that they can give you more specific advice and support.

SB

DTQ-20060211081121
Original posting 22 Feb 2006
Posted to Other

  
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Last Updated: Tuesday April 06, 2010 15:10:06
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