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July 22, 2004

Diagnosis and Symptoms

Question from Tucson, Arizona, USA:

Can type 1 diabetes show symptoms before actual onset? My daughter is six. Since she was two and a half, she has had poor weight gain, stomachaches, headaches, occasional vomiting, and episodes where I could swear she is drunk or high. I found the correlation to be with sugar and eliminated all sugars, except natural sugars, from her diet. Recently, we had an incident that prompted a glucose screening and celiac biopsy. Both came back negative. However, on my latest trip to my mom's, she had a behavior episode and my mom, who is diabetic, late onset, checked my daughter's blood sugar and it was 176 mg/dl [9.8 mmol/L]. Two hours after lunch and time at the playground, she was 206 mg/dl [11.4 mmol/L]. So, my mom sent an extra meter home with me. This week, I have found that fasting blood sugars are always good, 86 to 108 mg/dl [4.8 to 6 mmol/L], but we do not go a day without one high reading (176 to 206 mg/dl [9.8 to 11.4 mmol/L]). I can usually tell by her behavior when it is high and I check it and find this to be true. I feel like I am at a loss with doctors. Is it possible that she is developing diabetes? Or, could these elevated blood sugars be caused from a different disorder?

Answer:

Obviously, it is impossible to know if she will develop diabetes. You can continue to test, but you should not use insulin until she truly has diabetes. The potential exists to check for antibodies, but that is in a research setting, since you cannot prevent diabetes from developing.

For now, I suppose I would continue to test and look for elevated fasting numbers. We occasionally see numbers that are elevated after eating, but not diabetes.

LD

[Editor’s comment: For information on what tests you could have done on your daughter, see a recent Ask the Diabetes Team question.

BH]