
February 15, 2007
Diagnosis and Symptoms
Question from Canada:
My eight year old had a virus and was on prednisolone. On day two, he got very hungry; on day three, very thirsty, peeing, etc. I checked his sugar by a meter and it was 10.9 mmol/L [196 mg/dl]. The next morning, it was 4.7 mmol/L [85 mg/dl] fasting. At night, two hours after a meal, it was 14.4 mmol/L [259 mg/dl]. The pediatrician said to wait a week, then test it. We did and are waiting for the results. Once off the prednisolone, his sugars, mainly two hours after meals, range from 6.7 mmol/L [121 mg/dl] to 9.0 mmol/L [162 mg/dl] and his symptoms, while there, are less prominent. I checked him once a day. I’m hoping things turn out fine, but wonder if there are any cautions/red flags here that require follow-up. I’m expecting a normal fasting glucose, a mildly elevated postprandial and a high normal A1c (since I expect recent onset).
Secondly, I also checked his little brother fasting, just because, and he was 7.4 mmol/L [133 mg/dl] fasting. I’m not alarmed, but he hasn’t been gaining weight this past year and is complaining of headaches. He’s almost four. Does the fact that there are two of them with mild elevations change my approach in any way?
There is a strong history of type 2 in the family.
Answer:
Are you testing correctly? It might be useful to look for diabetes antibodies in both boys. These are ICA, GAD, IAA, etc. Steroids can raise glucose. I don’t know how many since most don’t test. The real red flag is 7.0 mmol/L [126 mg/dl] on two occasions at the laboratory or 11.0 mmol/L [198 mg/dl] with symptoms, again, at the laboratory.
LD