July 17, 2008
Diagnosis and Symptoms
Question from Grand Junction, Colorado, USA:
I have a toddler who was diagnosed with type 1 four months ago and have been watching my four- and seven-year-olds ever since. My four year old has been cranky and a little out of control at times, so I’ve checked her blood sugars since I had the monitor. Twice now, she has tested above 200 mg/dl [11.1 mmol/L] (this time 260 mg/dl [14.4 mmol/L]), but both times were immediately after she’d had a large, sugary desert, which could also explain the crankiness. She shows no other symptoms — no excessive thirst, although it has mildly increased since warm weather started. It looks like from reading your previous answers that what I want to do is get a reading in the morning before she eats and talk to a doctor if it is above 125 mg/dl [6.9 mmol/L]. Would it help to check for urine ketones?
One doesn’t get cranky from hyperglycemia as you described. And, unless the pancreas is unable to make insulin, one shouldn’t ever get such high sugar levels anyway. (I assume fingers were clean and there was no technical error with such a high result). So, this is worrisome. The risks for siblings getting type 1 diabetes are in the 2 to 5% range without other first degree relatives also with type 1 diabetes. Normal blood sugars don’t go much above 126 mg/dl [7.0 mmol/L] (some say 140 mg/dl [7.8 mmol/L] by home meters). So, I would do some profile blood sugar testing (before meals, one and two hours after meals) and then discuss this with your diabetes team to see if antibody testing or other testing is needed. Especially be wary if there is increased thirst, increased urination, enuresis or unexplained weight loss so that DKA does not develop.