Complications associated with poor glycaemic control

Children and adolescents diagnosed with type 1 diabetes have a great deal to gain from early and sustained good glycaemic control.¹ Poor control can lead to long-term complications, causing a drive to more intensive insulin regimens in order to reduce complication rates.⁴ Families or care givers of young children with type 1 diabetes are encouraged to be vigilant about good glycaemic control without increasing the risk of hypoglycaemia or its complications following intensified insulin control.^1,3,4

Hypoglycaemia and cognitive function in young children with diabetes

Naturally occurring episodes of acute hypoglycaemia in young children with type 1 diabetes may be associated with deterioration in cognitive function.^2,3

Severe hypoglycaemia is a significant and relatively common complication of insulin treatment. Early exposure in children has shown to reduce long-delay spatial response performance and long-term memory functioning. Very young children may be more vulnerable to the negative effects as their underlying neural systems are still developing.¹

Hypoglycaemia is a concern for parents of children with type 1 diabetes

Children lack the ability and reasoning to provide their parents with important information regarding their diabetes management. The risk of hypoglycemia is also more pronounced in this patient group due to greater insulin sensitivity and variable food preferences such as intake or refusal.^3,4

Parents often assume the majority responsibility for diabetes care when managing insulin dosing and carbohydrate intake. This is usually based on experience and intuition, which may leave them vulnerable to anxiety and fear of hypoglycemia is common.^3,4 Studies have also shown that mothers find nocturnal hypoglycaemia stressful in particular, irrespective of the number of hypoglycaemic episodes reported.⁴

Minimising the risk of hypoglycaemia in young children

Tighter glycaemic control reduces complication rates and severe hypoglycaemia can be minimised by appropriate self-monitoring of blood glucose, regular review of insulin regimen and attention to diet and lifestyle factors.⁴

This particular patient group may be dependent on adult caregivers to manage their treatment and is further complicated by variable exercise and diet. It is therefore important to choose a suitable insulin regimen which minimises the risk of hypos in young children with type 1 diabetes.

Share	0 0	Send to a colleague
URL