From Maine, USA:
My 15 year old daughter has had diabetes since age 3. She has a history of learning difficulties, i.e., speech/language impairments in the area of receptive language, poor memory and poor organizational skills. I've often wondered about the effect of fluctuating blood sugars on the learning process and also on the emotionality of people with diabetes over a long period of time.
Patients who have experienced recurrent episodes of acute hypo- and hyperglycemia have been reported to be more nervous/anxious and to score lower in "happiness" rating scales. In general, learning, attention, decisions and IQ performance can be affected during hypoglycemia, with women less affected in neuropsychologic function than men. At the other side, cognitive functions are generally well-maintained in IDDM patients even at substantially elevated levels of blood sugar, although no association has never been found between poor blood sugar control and an improvement in cognitive functions during hyperglycemia. Furthermore, near-hypoglycemia (symptoms of hypoglycemia with no chemical hypoglycemia) can affect many IDDM patients with poor metabolic control, although no relationship seems to exist between blood sugar control and cognitive deficits.
In your daughter's case, you might consider adapting (with the help of your clinic doctor) your daughter's insulin regimen to a more flexible one and to accept for her a suboptimal glycemic control, judged by glycohemoglobin level, to avoid jeopardizing her intellectual functions.
I hope this reassures you, and don't worry about modest fluctuations of blood sugar, because it's average control over long period of time that counts in this case as for all diabetic complications.
Original posting 29 Mar 97
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