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[IP] High bg's in children

> >Yes, we have used Humalog occasionally, but only if she is over
> >500 because 1/2 unit of Humalog will drop her blood sugar by 400
> >points in only 30 minutes....I guess because she is so small.  She
> >is only 23 months old and 25 lbs.  We haven't tried diluting her
> >humalog yet...her pedi endo seems content to let her sugars run
> >high rather than risk a low due to her age.  I hate that she usually
> >runs 300's but she is just not consistant...they are also mixed with
> >100's so I'm afraid to adjust her NPH.  I've only been at this for
> >barely 2 months and just really feel lost!  We go back to the pedi
> >endo on Monday...maybe he will be able to tell us what we should
> >do!

quoted from 

You are quite right when you ask whether and why high blood sugar does
not affect .... young
     children compared to older ones. This observation was due to the
     fact that pediatricians generally did not continue to look after
     their young patients after the adolescence or young adulthood and
     therefore quite rarely they could observe complications. The
     diabetes complications were described, on the other hand, mainly
     by adult diabetologists. The scientific explanation for that
     apparent inability of high sugar to exert its effect in children
     compared to adults was thought to be that the different hormonal
     milieu of puberty makes the individual prone to the damaging
     effect of high blood sugar. 

All this is not considered true any longer by pediatric 
diabetologists worldwide and a "priming" effect of
     prepuberty hyperglycemia on future complications has been
     described in clinical followup studies. This is why current
     practice recommendations are increasingly aimed for meticulous
     control from the beginning of the disease, i.e., a
     glycohemoglobin that is not greater than the 15% above the upper
     limit of the normal for the method used or as near to that as is
     reasonably possible given the age of the small child. 
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