September 10, 2008
Diagnosis and Symptoms
Question from Trumbull, Connecticut, USA:
My five and a half-year-old daughter recently went for a routine check-up for school at her doctor’s office. They did a urine test and found high levels of sugar. They also did a finger prick check and got a result of 250 mg/dl [13.9 mmol/L]. The next morning, after fasting, her blood sugar was back in range. They ran a hemoglobin A1c, which came back a little out of range at 6.7. They think she has the early onset of diabetes, but are not sure. She is continuing to have sugar in her urine. Could it be something else or is it most likely the early onset of diabetes? We are not getting much help and are just looking to get answers.
Answer:
Most laboratories in the U.S. are standardized for A1cs and 6.7 is high. We don’t diagnose diabetes based on A1c yet, but likely will soon. That said, the combination of urine glucose and the A1c makes we think she has diabetes, early, but diabetes.
You need to see a specialist (preferably a pediatric endocrinologist) and you need to monitor her blood glucose. You certainly don’t want her to get ill with very high blood sugars. We can test antibodies that will help you know if she is on the way to diabetes. If she has antibodies and her blood glucose is rising after eating, I would start insulin, but do not do so without proper instruction by the specialist.
LD
