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Question:

From Medford Lakes, New Jersey, USA:

If you follow your doctor's advice and keep your sugars in range as close as possible, will you definitely have complications of diabetes like high blood pressure, heart attacks, neuropathy. etc.? Or, can it be avoided? My six-year-old daughter was just diagnosed.

Answer:

Good for you for being proactive about your daughter's recent diagnosis.

For decades, it was logically assumed that good control of blood glucose would lessen the likelihood of diabetic complications, after all, people WITHOUT diabetes typically did not get the complications that poorly controlled diabetics acquired. In the 1990s, it was clearly shown through a now famous and important scientific study called the "Diabetes Control and Complications Trial" (DCCT) that the previous presumption was indeed CORRECT: good control of diabetes lessens the chances of diabetes-related kidney, eye, and nerve problems/complications. Now, I wish I could say that the DCCT showed that the risk of such problems improved 100%, but that is not true. The risks improved by upwards to 70%. But, it is important to note that while the aim of the DCCT was to keep glucose levels in near perfect control in the thousands of patients who participated (the majority of whom were adults to as young as late teens), only a minority (I think less than 5% or so) were actually able to completely improve their own glucose control, as measured by the hemoglobin A1c (A1c) test. I see that as great news! Your child does not have to be in "perfect" control to lessen risks of complications; you've got a lot of "cushion." Follow-up analyses of the DCCT showed that even in the younger patients who participated and who obtained some overall lowering of their A1c values still had less likelihood of complications years later, even if their later control slipped a bit! So, it has been extrapolated (but not proven) that even prepubertal children will benefit with good control of their diabetes.

So, do heed your doctor's advice (I'm sure hope that they would not tell you blatant untruths). Keep your child's diabetes in good control now; teach her good habits of insulin dosing, exercising, and meal planning now so that good control of diabetes will be second nature to her later on in her life. I think it is often helpful for the diagnosis of a child's diabetes to really be a diagnosis for the ENTIRE family. If her family members meal plan and exercise with her, it becomes EVERYONE's responsibility and your daughter may not feel as isolated as she might, although she is still getting the needle pokes, to be certain.

DS

DTQ-20080911124822
Original posting 12 Sep 2008
Posted to Complications

  
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Last Updated: Tuesday April 06, 2010 15:10:16
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