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April 11, 2007

Diagnosis and Symptoms

Question from England:

My 14-month-old son was in the hospital seven weeks ago with bronchial pneumonia. Since he has been home, he is displaying some symptoms of diabetes (increased thirst although not excessive, eating all the time while not gaining weight, always tired and crankiness). I asked my doctor to test him for diabetes. He said that if my son had diabetes, I would know already. Type 1 is my family. My brother was diagnosed at age five, so I used his glucometer and got the following results: before lunch--73 mg/dl [4.1 mmol/L]; right after lunch--200 mg/dl [11.1 mmol/L]; an hour after lunch--120 mg/dl [6.7 mmol/L]; after dinner--257 mg/dl [14.3 mmol/L]; one hour after dinner--140 mg/dl [7.8 mmol/L]. Should I be concerned? Are such varying levels okay?

Answer:

The blood glucose levels you report are normal before eating, but definitely very abnormal after eating. I would discuss this with your physician and consider consultation with a diabetes specialist rather than wait for your son to get sick clinically, get dehydrated, etc. Antibody testing would determine if there were already positive antibodies. Some research suggests that treating at this very early stage helps the damaged beta cells of the pancreas to last longer so that there is some theoretical, as well as clinical, reason to make such an early diagnosis, start insulin and a meal plan, etc. Certainly, you should continue close monitoring pre- and postprandial (before and after meals).

SB