March 19, 2006
Diagnosis and Symptoms
Question from Byron, Minnesota, USA:
For about six weeks, my six year old daughter has been complaining of abdominal pain and headaches nearly every day. They cause her to not even want to play much. They ran a routine urinalysis which didn’t reveal much, just some ketones and protein. I tested her ketones myself at home (my husband has ketone strips), and the level came out low to middle range. She does not really have any symptoms of diabetes other than becoming very hungry at times and fatigue.
I decided to try testing her blood sugar using the glucometer at home. The first number I got was 156 mg/dl [8.7 mmol/L] after five hours without food. I took another sample two hours after lunch and it was 354 mg/dl [19.7 mmol/L] and 326 mg/dl [18.1 mmol/L]. I took another sample before bed and it was 95 mg/dl [5.3 mmol/L]. The next morning it was 99 mg/dl [5.5 mmol/L] Then, one and a half hours after breakfast, it was 261 mg/d. [14.5 mmol/L] and 190 mg/dl [10.6 mmol/L]. Her pediatrician ordered a fasting glucose which came out to be 89 mg/dl [4.9 mmol/L] so they said “no diabetes.” They told me my machine was probably faulty, but I was testing myself at the same time as her, and all of my own levels came out in the normal range. Any idea what could be going on? Should I insist on an A1c or a glucose test?
Answer:
Random high glucose does occur. Diabetes is sustained when one’s blood sugar is over 200 mg/dl [11.1 mmol/L] with symptoms or 126 mg/dl [7.0 mmol/L] fasting on two occasions with laboratory tests, not home glucometer readings. This is why there are many questions raised about quality control, as even a drop of sugar on the finger can result in very high numbers, etc.
That said, if you are really worried about diabetes, try some urine strips Your daughter will be impressed and if you get sustained glucose in the urine, I promise the pediatrician will be impressed. The A1c is not used to diagnose diabetes.
LD
