November 11, 2005
Diagnosis and Symptoms, Other
Question from Las Vegas, Nevada USA:
My two year old son and six year old daughter have both been referred to a pediatric endocrinologist. My son started with hypoglycemia at 14 months old after being very ill. He now has daily highs of 150 to 300 mg/dl [8.3 to 16.7 mmol/L], but also lows from 40 to 70 mg/dl 2.2 to 3.9 mmol/L]. My daughter started having problems in September. She was hospitalized last May for possible cyclical neutropenia. She had intense stomach pain and a low white blood cell count. Now, she has shown weight loss, and urinary problems so we started checking her sugar. She has been as high as 580 mg/dl [32.2 mmol/L] and come down within two hours. She has daily highs and lows also. They have had many blood tests showing they make very little insulin, yet they have not been put on insulin yet. Can children have pre-diabetes for type 1? This is what the endocrinologist is thinking is happening to them. I am concerned that they just keep hanging with no diagnosis yet we keep getting told they definitely don’t have normal blood sugar or insulin levels. They are both being tested six or seven times a day and seeing the endocrinologist every 90 days. I’m looking for any information that can help me or help them to have a diagnosis.
Answer:
It is impossible to make a diagnosis via the Internet. Those are definitely not normal blood glucose levels that you report. I would agree with seeing a pediatric endocrinologist to help sort this out. Pre-diabetes is likely a possibility as are autonomic neuropathies and gut dysmotility disorders. Antibody testing with islet cell, GAD and research-level insulin antibodies may be helpful but only if positive; if negative, they won’t help. A colleague, Dr. Charles Stanley, at Children’s Hospital of Philadelphia may also be interested since these types of problems are related to some research that he is doing. But, go to the pediatric endocrinologist and bring all the specific information already gathered.
SB
