September 27, 2008
Diagnosis and Symptoms
Question from Destin, Florida, USA:
Because my 15-year-old daughter was symptomatic for diabetes, we took her to an endocrinologist for some help. He found that she had a slightly elevated fasting glucose test and requested that we periodically check her using a blood sugar meter. Her symptoms, since March, include extreme thirst, frequent urination, and not putting on any weight. Her blood sugar ranges from 50 mg/dl [2.8 mmol/L] to 230 mg/dl [12.8 mmol/L]. When she gets below 65 mg/dl [3.6 mmol/L], she does have hypoglycemia symptoms and has almost passed out several times. We are sure we are using the correct technique to test. My daughter has also had an A1c test, antibody testing, and insulin levels measured. Her A1c was 5.9, insulin was on the low end of normal, and antibodies came back negative. We have had other tests done to rule out everything. Our doctor is scratching his head not knowing what to do. Is there anything besides diabetes that would cause symptoms and crazy blood sugars? Can diabetes come on like this? How should we proceed?
Answer:
At 5.9, the A1c is the upper limits of normal for most laboratories. It is still not diabetes as it is not diagnosed until you have two fasting blood sugars, tested by a laboratory, over 126 mg/dl [7.0 mmol/L]. With negative antibodies, it doesn’t sound like classic type 1. If you have not yet done so, you might want to contact TrialNet and send blood, if you qualify. Certainly, at present, I wouldn’t diagnose diabetes or give insulin.
LD
