Long-term complications resulting from High blood Glucose

[glevert]

Hi all,
My son has been diabetic for a 3 and a half years now.
His blood glucose is normally within range but he had many times per week, some days with spikes up to between 15-20 mmols. His endocrynologist recommends he tries to stay between 4-7 mmols. He turned 14 in January 2007. We are told that his growth spurts can affect his blood glucose (high values on his glucometer). I am concerned that if he keeps having too many high blood glucose levels, he would develop other problems either with kidneys, or else. He is using Humalog and Humilin injected with a seringe twice a day. Hi last A1C was around 7.2. He is a fairly active kid and will be going in a high school sport-study program where he will have to train about 2-3 hours a day for speedskating, including dryland (running, track and field) and ice training, weight training, yoga, etc... - 5 days a week.

Am I worried for nothing or can there be serious complications coming up in a few months or years?

Thanks for your help!

Guy

[glevert]

Thank you very much for your comment!
Very educating for me and we are seeing his doctor this week.
This helps me and my son understand.

This Forum is so great!

Have a great day.

Guy

[JDRF-VOL-SG]

Nobody can say for sure whether the high levels will cause complications in your son in the future... for some reason, some people tend to get the complications while others don't even if glucose levels are higher than ideal. Researchers tend to think that there is a genetic component to why some folks seem prone to complications no matter what they do while others seem to not be as likely to get them. All I can tell you for fact is that studies have shown that a1c levels at 7.0 or below seem to protect people from complications.

So the real issue isn't so much the occasional high level, but how long it is left high and how often this happens. The a1c is the best test of overall control, and your son is close to the goal level. For some, going to pump therapy seems to be the best way to keep the sugar levels stable, while for others there are other insulin regimens that work best.

I am not a medical professional -- I am a long-time type 1 diabetic, diagnosed at about the same age as your son. What I have seen is that each person is different, and the most important thing is to find the best regimen for each individual. If he is having some high spikes and they seem to be happening more often than they used to happen, maybe it is time to rethink his humulin and humalog. Maybe considering a pump or considering the 24-hour Lantus and a quick-acting insulin like humalog or novalog are worth discussing with his doctor.

His a1c level is almost where the goal level is set, so this is encouraging. Many diabetics nowadays are able to keep the a1c comfortably around 6 or sometimes even in the 5's, so there is room for improvement. However, he is at a volatile age, and some doctors don't want to tighten up glucose levels too much until kids are older teens and are more responsible for treating hypos and high levels. His active lifestyle may make it hard for him to tighten up much or even any at all without risking severe hypoglycemic episodes. Extreme exercise can cause glucose levels to rise temporarily and then drop many hours later because our bodies tend to dump adrenalin when we exercise. This may be what is causing his recent high levels.

My recommendations are pretty straight-forward. First, you and your son may want to talk to his doctor to see if some new insulin regimen may suit his lifestyle better. Secondly, he may need to start testing his sugars more often, and adjusting by taking a few units more quick-acting Humalog if his sugar is high. We all can make mistakes, and if we correct them quickly, then the levels don't stay high for very long. They can do little damage if normalized quickly when they spike up.  Your son may need to discuss this possibility with his physician and it may solve the problem. Testing often and adjusting often is how I manage my glucose levels, and it works well for me. By testing before meals and also at least once in between each meal boils down to about one glucose test every 3 hours. If I am low, or seem to be on the way down, I drink a small amount of juice. If my test come in high, I take an appropriate amount of quick-acting to lower it. The result is that my sugar levels are never out of range for more than a couple of hours. After almost 38 years on insulin, I have no complications. I wish your son the same good health.