April 25, 2006
Diagnosis and Symptoms, Hyperglycemia and DKA
Question from Manchester, New Hampshire, USA:
I have insulin dependant gestational diabetes (for the fourth time/fourth pregnancy). Yesterday, while I was checking my blood sugar in the morning, my three year old son was watching me like he always does. He is very curious. He asked me if I would poke his finger. I said sure, why not, what harm can it do? The result was 183 mg/dl [10.2 mmol/L].
Thinking he must have something sticky on his hand, I washed his hand with soap and water and poked a finger on his other hand and got a second reading–182 mg/dl [10.1 mmol/L]. He had eaten half a cereal bar and a few sips of milk about 45 minutes prior to me testing him. I figured it must just be a fluke so I put it out of my mind for the day and sent him off to school like normal.
This morning, I decided I should just check a fasting sugar on him. His blood sugar was 150 mg/dl [8.3 mmol/L]. My blood sugar was only 94 mg/dl [5.2 mmol/L] (normal for me right now) and calibration was done on the meter only three days ago.
I called the pediatrician this morning and took him in. There was no sugar in his urine, which I know is a great sign! In the afternoon, he had blood work done. His random glucose was 83 mg/dl [4.6 mmol/L] and, by the same meter, I got a result of 90 mg/dl [5.0 mmol/L] for him. His A1c was 5.5%.
As far as symptoms go, he has been really moody and tired lately and has been having random pee accidents during the past month, after being completely potty trained for almost nine months. He has even had two accidents this week. He hasn’t been drinking a lot more than normal and his appetite has been variable. Some days he is really hungry and other days he says that his tummy doesn’t want to eat. There’s been nothing that would have made me even think of having him tested for type 1 diabetes.
Is it possible we have accidently caught him in the early stages of diabetes? If this is diabetes, how long could it take for it to become full blown?
Our pediatrician consulted a pediatric endocrinologist who recommends we test his evening urine for sugar and call if we ever get a positive strip. He doesn’t want any follow up appointments or follow-up blood work. I also asked about antibody testing and was told that was only done in children who’s parents are type 1 diabetic.
Have you heard a story like ours? What was the outcome? Was diabetes ever diagnosed?
Answer:
I agree with the endocrinologist who has suggested monitoring with urine test strips occasionally. I would also monitor for the signs and symptoms of diabetes including excessive thirst, weight loss, excessive hunger and frequent urination. If your son develops those symptoms, he will require further testing. Most of the time, checking an otherwise asymptomatic child for diabetes using a handheld glucometer is a bad idea; it just confuses parents. There is a possibility that your child may be in the very early stages of diabetes, but I suspect that without other symptoms of diabetes, it is not likely that he has diabetes at this time.
MSB
