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Hypos and long term effects

Discussion in 'Parents of Children with Type 1' started by zuzinka, Jan 7, 2013.

  1. zuzinka

    zuzinka Approved members

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    I need your help, especially the ones with T1. My 6 year old daughter has got T1 since 2,5 years. We have her under very tight control together with lower carbs as well as sensor and insulin pump. Our H1Ac for the last year is always under 7, todays one 6,4 which I am very happy and I know that its because of our tight control. But of course to achieve such A1c we do have once a while hypos, nothing very low but at around 50 comes once while. Now we got a new doctor who said that hypos are not good long term and that it damages brain and slows reactions. He said once a month is ok but daily or weekly no way. Also he said that anything below 7 is not advisable for small kids even though we have sensor. Our previous doctor always encouraged us to stay at lower as long as we can control hypos and treat her immediately incase one comes. Now I need you advice on how damaging those Hypos are. I am talking about 5 minutes hypos, nothing long time, because either she feels it and tell us or sensor beeps and tells us so we treat immediately.
     
  2. Sarah Maddie's Mom

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    I can only say that our endos (and we've had a couple) would not be phased by a weekly 50.

    Daily hypos in the 50 range and they would most probably want us to address it.

    Given the extent to which you are aggressively managing her bg I would not point to the weekly hypos as a problem, though I might be concerned if the lower carb diet was restrictive enough to have an impact on her brain development. Are you working with a dietitian on that end?
     
  3. Jacob'sDad

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    I can't see how such short term hypos can be a problem. It would be different if she were low for a long time several times a week, but you are heading them off very quickly.

    Sometimes I don't think endo's can believe that such tight control is possible and they "assume" that it must be the result of too many lows. You know the truth so I personally don't think you have anything to worry about.
     
  4. mysweetwill

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    We've seen three endos in the past year since my son's diagnosis (dont ask! but all three are at highly reputable diabetes centers in the northeast). His A1C has ranged between 5.8-6.2. We have never been told that weekly or monthly lows are too much, although clearly, when there has been a pattern of lows we have made necessary adjustments to his ratios.
    We, in fact, have been told from each center that tight control is optimal and the only way to preserve the functioning beta cells he may still have. I know this type of control will only become more difficult as he enters puberty and exits his honeymoon stage so I am hoping we can hold on to this for as long as possible.
     
  5. dshull

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    Our son is 8 and was diagnosed 5 months ago. His most recent A1C was 6.3. The endo acted like that was fabulous. Now he does not fall low very often - he is generally somewhere between 110-180. The endo said that what he does not like to see is a ton of highs and a tons of lows, which then average out the A1C in the middle. I think you are doing a great job. We, too, were told that the best way to keep the honeymoon going and preserve his beta cells were to keep his A1C down so we also have been working hard to keep very tight control. We do not restrict what he eats, and he eats about the same as he did before diagnosis, but we do weigh and measure everything.
     
  6. Christopher

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    You are achieving good A1c's without having daily or weekly hypos. I would not pay any attention to what the new endo is saying.

    But I will echo what Sarah said about the low carb diet. Not only could it be preventing her from getting what she needs physically, but you also have to consider the emotional impact it may be having on her as well.
     
  7. Lee

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    We are actually told that a weekly hypo should be expected with tight control. It sounds like you are managing it fine. How many carbs does she get? I think the bare minimum for brain growth is 120 carbs a day. Brains need carbs to grow! :eek:
     
  8. swellman

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    I would ask for a study to support his assertion.
     
  9. natallia

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    what swellman said. my son is 21 months old. our last a1c is 6.0, the one before 6.2. We keep him between 4-8, meaning really tight control with finger checks at least every two hours and full time cgm. yes, we have hypos too, on average 2 per week in the 3s and maybe once a month in 2s. once our endo check our bg records he was very happy and said even though, the advice is to keep him between 6-12, he doesn't see a reason why we cant keep him at tighter range since we check like crazy anyways....The bottom line is the closer a1c to a normal person's range, the better. without lots of hypos, of course.
     
  10. SarahKelly

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    hypos and hypers are just part of it, maybe that's flippant, but truly we can not completely control how things go we do our best and react to what we see. So, he's just stating his opinion, I do remember a paper a while back that showed some consistent lack of focus with children that have consistent hyperglycemic episodes (the paper had more details about the amount, duration, etc) but it was a really large number. Our sons endo gave me several papers backing up the opinion that irregular hypos (even ones that cause seizures) aren't damaging long term. She was great about doling this out as Isaac had a hypo induced seizure at 21months and she was trying to do her best to reassure me that I hadn't ruined him :cwds:
    Not sure if that helps, but I believe that you guys are putting your child's best interest at heart - as long as your child is growing, thriving and learning at a normal rate I wouldn't react to the endo's comments.
     

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