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From Newfoundland, Canada:

My grandson has Type 1 diabetes and is under a doctor and a nurse and a dietitian who work as a team. I was wondering, is it harmful when sugars fluctuate as they are for him? When the sugar level goes up to 25 [450 mg/dl], that to me is high or is it high? That is the question I have for you. What if any damage is or can be done when the sugar levels go up high like this or is this normal in a juvenile diabetic? Can he go into a coma when the sugar levels are up so high? What are the consequences?


Blood sugar levels up to 25 are certainly too high; but without a lot more information about your grandson's insulin doses, blood sugar at other times, HbA1c levels, amount of exercise and food intake, it's hard to specify exactly what the problem might be. Nonetheless, blood sugar fluctuations, fasting or after meals, can happen in a juvenile diabetic patient, quite often in adolescents, and they are not dangerous provided they are few (i.e. most of his other blood sugars are acceptable) and last for a short while (make sure your grandson does not have ketones in the urine with a blood sugar over 250 mg%) and the HbA1c values (an overall picture of your grandson's metabolic control over time) are not greater than the 15% above the upper limit of normal for the method your grandson's diabetes team uses. No one can keep all of his blood sugars in the desired range! Very important thing is to be able to counteract very high blood sugars with extra insulin as recommended by your diabetologist.

To sum up, don't worry about short fluctuations of blood sugar because it's average metabolic control that counts in the prevention of all diabetic complications.


Original posting 11 Feb 98


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