August 24, 2000
Diagnosis and Symptoms
Question from Whitehorse, Yukon, Canada:
Our three year old grandson had a ketone smell on his breath, and when his blood sugar was tested by his grandfather, who has diabetes, it showed 16.3 mmol/L [293 mg/dl](4 to 8 mmol/L [72 to 144 mg/dl] normal). Five hours later at the hospital his blood sugar was 4 mmol/L (72 mg/dl). We know grandfather’s glucose meter works at least on a relative basis because he uses it daily, and it shows wide variation in sugar. Does diabetes develop slowly in a child? Could his pancreas be working at times and then not? We are worried — should we be?
Answer:
You shouldn’t be worried at all. In childhood type 1 diabetes, the progression of the autoimmune process toward severe insulin deficiency and high blood sugar is, most of the time, faster than in the adulthood form. It is not irregular in such a fast way that a frank high blood sugar can spontaneously normalize after few hours.
Last but not least, how can his grandfather keep relying upon that glucose meter for monitoring his blood sugar values?
MS
[Editor’s comment: We recently posted an answer to a question sent in from a reader about this response.
JSH]
