December 3, 2003
Diagnosis and Symptoms
Question from Harpswell, Maine, USA:
My two-and-a-half-year-old son has had an increase in his thirst over the last two weeks. My husband has type 2, diagnosed nine years ago. My son’s meter readings have been 192 mg/dl [10.7 mmol/l], 292 mg/dl [16.2 mmol/l] before breakfast, and 247 mg/dl [13.7 mmol/l] before lunch. I called his pediatrician and she ordered a GTT, BMP, and electrolytes. His A1C was 4.4, his random glucose was 76 mg/dl [4.2 mmol/l] and his GTT was 88, Na 143. She has been consulting with a endocrinologist in a bigger city near us but they haven’t given us any reasons for his high fingerstick readings. They aren’t sure why. His thyroid test was normal and they also tested him for celiac disease (not back yet). Any other ideas? She is open to anything. We’ve checked his blood glucose on more than one machine and gotten high readings on both at the same time.
Answer:
This certainly is a strange matter; the meter readings are for sure in the diabetic range; on the other hand when you have done some exams at the laboratory they resulted in the normal range.
One question? When you have done the readings of blood glucose levels with the meter, was your child taking any drugs that could influence the blood sugar level?
Then, for a more careful examination of your child I suggest you can do two things: first of all, an oral glucose tolerance test in order to evaluate the blood sugar levels both at fasting and during a challenge; secondly, you can test for antibodies (ICA, GAD, IA2) that if present could help you to know better what is in the process.
The familiarity with type 2 diabetes that his father has is not a marker for type 1 diabetes in your child; in fact there is no relationship between type 1 and type 2 diabetes.
AS
