May 9, 2001
Diagnosis and Symptoms
Question from Anderson, South Carolina, USA:
My seven year old son was diagnosed with type�1 diabetes a year and a half ago, and my other two sons (ages one and a half and five) have had random blood sugars over 200 mg/dl [11.1 mmol/L]. My younger son has had very wet diapers in the past four months, but that seems to have tapered off. He still drinks quite a bit, but not to a large extreme. I recorded one random reading over 300 mg/dl [16.7 mmol/L] so the doctor ordered a modified glucose tolerance test (I fed him a high carb meal and they tested his blood two hours later). This test was performed on him twice, and both times the results were “within normal” range. My five year old has never had this test, as his high readings were discovered within the last week.
I am very concerned about these high readings, and yet the tolerance tests do not reflect a problem. I know that the meter is correct because I base my seven year old’s insulin requirements on it’s readings, and he is in good control.
My questions are:
Could these high reading be attributed to anything else?
Should I be more persistent in asking for help and direction in dealing with this?
My pediatrician and endocrinologist have both advised me to stop the blood checks on my younger children, and basically, wait and see if any other symptoms arise. Do you think this is the right course of action?
Are there any other tests available that might provide us with additional information?
Answer:
I am assuming that your eldest son does indeed have type�1A (autoimmune) diabetes and quite understandably, you are worried that this might develop in the other two boys. However, home blood sugars in this setting, whether random or fasting are notoriously unreliable in young children because you communicate your anxiety and this plus the sight of a needle puts up blood sugars in moments. A really experienced nurse can get around this and another way is to use one of the newer meters that use tiny blood samples. So, I think that the boys’ pediatrician and endocrinologist are quite right in what they advise.
Just the same, I sense that you yourself need further reassurance and one way to get this would be to ask the pediatrician to send blood samples to one of the reliable commercial laboratories for antibody testing like Quest Diagnostics which would cost you around $100 or to call 1-800-425-8361 which is the central office of the national DPT-1 (Diabetes Prevention Trial). They will give you the number of the nearest participating center who will certainly test your middle son, and, if it is positive, offer participation in the oral insulin trial. Your youngest son would be below the age limit; but they might test him anyway — even though the test would be more reliable if you waited a few months.
DOB
