August 21, 2003
Diagnosis and Symptoms
Question from Pinckney, Michigan, USA:
I have a blood glucose monitor because I am insulin resistant, and my teenage daughter has type 2 diabetes, and the other day, my nine year old was irritable and hyper after a meal, and she was going pee a lot. I thought I would test her, expecting that she had a hypoglycemic crash (she is not diabetic), so I expected her blood glucose to be 40 mg/dl [2.2 mmol/L] or something. She had eaten three and a half hours earlier, and her blood glucose was 165 mg/dl [9.2 mmol/L] which I thought was high, so I have been monitoring her for a week.
Her fasting blood glucose has been 85-110 mg/dl [4.7-6.1 mmol/L], but after lunch yesterday she had readings of 245-310 mg/dl [13.6-17.2 mmol/L], and it was 375-429 mg/dl [20.8-23.8 mmol/L] after dinner. Each time it has registered so high, it has been about 10-25 minutes after a meal, and within another half-hour, it is back down.
I frantically the doctor who told me to take her to go to the emergency room where I was told that it is normal for blood sugar to rise, even that high, after a meal, and no one ever tests their blood sugar right after a meal for that reason. They said that the pancreas kicks in and lowers it and hers did. Because her fasting blood sugar and hemoglobin A1c normal, (4.9%) were normal, they said she is totally fine.
While I understand that it is normal for blood sugar to rise after a meal, and, in someone with diabetes, the pancreas doesn’t kick in and lower it, that is why they need insulin. Even though hers did, my gut feeling still says that something is wrong. I am even wondering if perhaps I stumbled onto a very early stage of diabetes that isn’t registering in her A1c, and she isn’t “sick” from it yet, but her pancreas is acting slowly in getting the insulin out because it is starting to disfunction.
Why would my daughter’s pancreas allow her blood glucose to get that high before kicking in? I thought anything over 200 mg/dl [11.1 mmol/L] anytime, even after meals, was too high. I don’t’ feel comfortable just believing that she is normal. Am I being neurotic or are the doctors always right?
Answer:
The values that you quote are certainly high. The diagnosis of diabetes is rather arbitrary, and it is clear that your daughter doesn’t have it. However, I agree with you that it is worth keeping any eye open for symptoms given your strong family history. I would discourage further testing unless she develops diabetes symptoms of excessive drinking and urination. If your daughter is overweight, then it is extremely important to tackle this now because any tendency to develop type 2 diabetes is reduced by being ideal body weight.
KJR
[Editor’s comment: See Classification and Diagnosis of Diabetes guidelines.
SS]
