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August 18, 2003

Diagnosis and Symptoms

Question from Cincinnati, Ohio, USA:

I have one daughter with diabetes, and because my younger daughter was ravenously hungry and constantly eating but not gaining weight, had yeast infections/itching, cold and thirsty, I tested her blood glucose level. Four hours after since she had eaten, it was 169 mg/dl [9.4 mmol/L]. The next day, I tested it again, and it was 180 mg/dl [10 mmol/L] after breakfast, 174 mg/dl [9.7 mmol/L] a couple of hours later, and 301 mg/dl [16.7 mmol/L] after lunch. Her blood glucose came down quickly, and within a couple of hours, it was only 86 mg/dl [4.8 mmol/L].

Her blood glucose levels were normal for he next couple of days. However, on the third day, it went up to 439 mg/dl [23.4 mmol/L] 20 minutes after eating, but by the time they saw her at the hospital, several hours later, it was 120 mg/dl [6.7 mmol/L]. The doctors there did a urine test and A1c, both of which were also within normal limits, so they said she didn’t have diabetes.

I watched her for the next week, and her blood glucose levels have been within normal range with a few slightly high ones after eating. Her pediatrician said that sometimes blood glucose goes up after eating and that is fine, and as long as her fasting blood glucose is okay, she doesn’t have diabetes. He suggested a monitor error, but I calibrated it, checked it on myself and my other daughter, and it was working fine. Her hands were washed after eating as well.

I read some of your other questions and wonder if she could be in the beginning stage of diabetes, during which her pancreas doesn’t work as well after eating a large meal or carbs, but works okay fasting. As a mother, I am confused and concerned and don’t want to ignore this.


From: DTeam Staff

It sounds like this, unfortunately, could be the beginning of diabetes. Most likely the pancreas can sometimes make sufficient insulin but not all of the time, and you are nicely documenting this erratic beta cell behavior. Please contact your diabetes team since they will likely do some antibody tests to help determine her risk status as well as help you decide how to monitor so that she does not get sick, have DKA [diabetic ketoacidosis], etc.