From Chicago, Illinois, USA:
My son, who just turned two, has had diabetes for nine months. Since he was diagnosed, my wife and I have had an impossible time keeping his blood sugar levels in a consistent target range. We just tried a week of carbohydrate counting, without much success. Should we just resign ourselves to the fact that always keeping a toddler's blood sugar between 150-300 is going to be impossible?
Yes; if you can get the glycohemoglobin to less than 2% above the lab's upper limit, that's great control for a child this age. (In reality, many kids this age run a glycohemoglobin about 3% above the upper limit of normal.) Occasional highs and lows are inevitable, as children this age are unpredicable in terms of eating and activity.
Children this age seem to be protected from the development of complications that are usually thought of as occurring from high sugar, and we are very concerned about the dangers of low sugar in toddlers. There will be plenty of time later to tighten up the control.
A child this age should under the care of a pediatric diabetes team to help address developmental issues. Also, there's a chapter in Sweet Kids: How to Balance Diabetes Control & Good Nutrition with Family Peace that addresses these children's special needs.
Original posting 20 Dec 97
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