August 9, 2003
Diagnosis and Symptoms
Question from McKinney, Texas, USA:
I felt my 11 month old son was thirsty and having more wet diapers, so I checked his blood sugar a few times since I have type 1 diabetes myself. It was 174 mg/dl [9.7 mmol/L] before dinner and 210 mg/dl [11.7 mmol/L] afterward. I checked him a few other times and got readings ranging about 140-220 mg/dl [7.8-12.2 mmol/L].
I called the pediatrician who tested him and got a reading of 211 mg/dl [11.7 mmol/L]. However, he had no sugar in his urine, and his hemoglobin A1c was 5.6%. About a week later, his fasting blood sugar (in the doctor’s office) was 78 mg/dl [4.3 mmol/L] at about 10:30 AM. Of course he hadn’t eaten anything in about 14 hours at the time.
The doctor says he doesn’t have diabetes, but I should just keep an eye out for symptoms, especially weight loss. (He hasn’t really lost or gained in past three months, staying around 23 pounds.) What do you think?
Answer:
With a family history of type�1 diabetes, I really understand your concern regarding your son’s risk of developing it. In addition to looking at your son’s symptoms and the accuracy of the blood sugar levels, I’d check him now for the presence of autoantibodies (ICA 512, GAD 65 , and anti-insulin). These are markers of a current or increased risk for type�1A (autoimmune) diabetes, especially among people with a positive family history.
Blood sugar levels checked by glucose meter are not accurate enough to make a diagnosis. A fasting blood sugar greater than 126 mg/dl [7 mmol/L] or a random blood sugar greater than 200 mg/dl [11.1 mmol/L] on two separate occasions and performed by a lab is the standard. Ask your son’s pediatrician for a referral then to a pediatric endocrinologist or a diabetes center with experienced in the prediction and prevention of type 1 diabetes.
MS
