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The Dangers of Suddenly Improved Glyemic Control (MDIs to PUMP)..please read.

Discussion in 'Parents of Children with Type 1' started by neuropathicmum, Sep 7, 2010.

  1. StillMamamia

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    I have never heard of this. Interesting. Will add to my list of questions for the endo.
     
  2. Lee

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    Oh - I recently read a study on this - I will see if I can find it! However, it did say that it dissipates in most children within a few months! I hope your sin finds relief!
     
  3. MReinhardt

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    Lee, I would be very interested in the study if you can find it! Thanks!!
     
  4. BrokenPancreas

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    Again, I was told not believe everything I read on the internet.:rolleyes:

    I do believe the poster, but I AM NOT TO RUN HER HIGHER because of this one case.

    With all the seizures and hypos your son was having for all those years, did you not consider a CGMS? Also, why did you wait so long to put him on the pump with all these problems since you said that the pump causes less problems?

    Does your son have other medical problems aside from D that caused these lows?

    Also, why are you bringing up the Dead in the Bed Syndrome?

    I'm just curious as to your reasoning of your post? Thanks
     
  5. Flutterby

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    I think this is the key.. doesn't matter if its pump or shots.. after being high for so long and then coming down and being closer to in range most of the time.. doesn't matter the route (pump or shots) its the coming down fast after years of being higher that is the problem.
     
  6. danismom79

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    Every article I'm pulling up about acute painful diabetic neuropathy is case studies with very few patients.
     
  7. Lee

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    I just want to stress that this is a REAL and Documented issue. This is from the ADA:
    Acute sensory neuropathy is rare, tends to follow periods of poor metabolic control (e.g., ketoacidosis) or sudden change in glycemic control (e.g., ?insulin neuritis?), and is characterized by the acute onset of severe sensory symptoms (as detailed below) with marked nocturnal exacerbation but few neurologic signs on examination of the legs.

    Simply do a Google Search on Insulin Neuritis.

    Here is one study I found - feel free to pm me your email addy and I will send them onto you:
    Acute Painful Neuropathy (Insulin Neuritis) in a Boy Following Rapid Glycemic Control for Type 1 Diabetes Mellitus

    This is from 2003 and this boy had a dramatic decrease in A1c - from 14.1 to 7.6 - here is the theory behind the cause of pain:
    Parasthesias, dysesthesias, and pain are believed to be attributable
    to spontaneous depolarization of nerve fibers. The acute onset
    of painful neuropathic symptoms in this setting could reflect repair
    and regeneration of damaged nerve fibers, along with improvement
    of disease.7 It has been suggested that initiation of good control
    can promote axonal regeneration and that the pain results
    from the ectopic generation of impulses in the regenerating axon
    sprouts.
     
  8. Lee

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    I also want to add that even though this does happen - parents aiming for better control should not let this hamper their efforts.

    While this is a true issue, and it is scary, it is also EXTREMELY rare - much less rare then the complications of running higher.

    I feel very bad for the parent and son who are experiencing this and hopefully he will soon return to normal - or at least Type 1 normal.
     
  9. danismom79

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    I think some people may confuse it with "regular" neuropathy. This is something different. How many of us have seen our children's A1c nearly halved after starting insulin? My daughter went from 13.9 to 7.2 in the first few months. But her daily numbers were brought down very slowly - 400s to 200s over a period of weeks. This is why it worries me a little when parents with newly diagnosed children get frustrated by the progress their endos are making. Faster isn't always better.
     
  10. emm142

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    I have to agree. I went from "over 14" to 7.2 in the first six months, but my BGs were extremely high at dx, pretty far over 600. I had a couple of weeks in the 400s, about a month in the 200s, and then eventually got into more "normal" BGs. They told me at the hospital that it could be really dangerous to bring them down to target range right away.. I just did what they told me to. :p
     
  11. hawkeyegirl

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    I think it's probably pretty rare even when kids are brought down into range quickly. Jack was 12 or 13 at diagnosis, and his a1C 3 months later was 6.8.
     
  12. wilf

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    DD went from 12.3 before diagnosis to 5.9 in 2 1/2 months.

    If, heaven forbid, my other daughter developed Type 1 then knowing what I know now (and the information in this thread notwithstanding) I'd be working my butt off to bring her down just as fast.. :cwds:

    The title of this thread is off, as is the message that it conveys. The title clearly suggests that suddenly improved glycemic control is dangerous, with the suggestion that going from MDI to a pump could also be.

    It would have been better to title it: "One in a million diabetes complication affected my son". And then to describe what occurred. This would help parents recognize the symptoms if they ever cropped up.
     
  13. Lee

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    Wilf, this is a first time poster whose son is going through something awful...a little compassion would be nice.
     
  14. Christopher

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    I thought it was very clear what the message of the thread was. And luckily, people can title their threads whatever they choose.
     
  15. wilf

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    The message, sometimes explicitly and sometimes implicitly expressed, is not one I agree with..
     
  16. madde

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    I read it as a mother who has fought very hard to find out what was causing her son's pain/symptoms. And when she found out the cause, she wanted to pass on her findings in hopes of helping another child who may need the information she has discovered.

    To the original poster, I appreciate you posting this!
     
  17. Lawana

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    The message being what, that rarely, there can be complications from a rapid decline in average bg?

    It is a known phenomenon that rapidly declining average bgs can result in complications such as retinopathy. I came across this information a few years ago, during my research about diabetes. The source I read did not include info about neuropathy, but that is not the point. The OP's son experienced a rare complication. She posted her experience. If my child had experienced excruciating pain which was "blown off" by the medical establishment, once I found the cause you can bet I would want to get on the highest mountain and proclaim the news to any and all who might possibly be affected in an effort to save at least one child the agony which mine had experienced. No where did I read that she recommended allowing dc to continue with high bg levels indefinitely. No where did I read that she recommend leaving a child on shots when a pump would bring bg levels to a much more satisfactory level. What I read was that there was, for her son, a serious consequence for the rapid decline in average bg levels, even if the ultimate destination, lower bg levels, was an understandably laudable and worthy goal.

    I am enriched through her post. I am aware of something that I was unaware of before. I may never need the information she posted, but on the other hand, I may come across someone for whom this information is life altering. It grieves me that you, who have had such a positive impact on the lives of many children with diabetes, including my own, would be so discouraging to someone that is clearly, to me, trying to help, not hurt, others.
     
  18. MikailasMom

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    What is dead in the bed syndrom?
     
  19. SarahKelly

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    I agree... it seems on here there is some unknown code of what is okay and what isn't okay to post in a subject line. I got blasted a while ago because my subject header wan't okay with a few of you regulars. And you know what, get over it. We're not perfect, we say it like we would in person. It's hard sometimes on here with some of you acting like the rest of us just need to think like you...guess what, we're all different and we all need to use our intelligence to read threads fully. Get over the subject line. I think whenever people can bring any information or studies up to us that's great, then each of us can take from it what we need or don't.
    I appreciate any additional info no matter what it says. I just think it's odd when people seem to want to dispute scientific studies and make it opinions. The study doesn't mean you're doing anything wrong. It's just facts. Diabetes sucks arse and we can only do our best for our children and in my case my spouse...none of us want any of the complications to occur so the more info the better.
     
  20. SarahKelly

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    perfect...I agree completely.
     

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