June 18, 2009
Hyperglycemia and DKA, LADA and MODY
Question from Denham Springs, Louisiana, USA:
I have a question about MODY. Is it possible for it someone’s blood sugar to spike really high then be normal two hours after eating? With MODY, will there always have a high blood sugar after eating or is this something that will not occur all the time?
My son is two and a half years old. For about six months, he complained about “ants” on his finger and toes. I’m not sure if it was pain or tingling. The doctor said it may be Restless Leg Syndrome or he just likes saying ants. About a month ago, this bothered me so I had my dad, who has type 1, check my son’s blood sugar. It was 180 mg/dl [10.0 mmol/L] about an hour after eating. An hour later, then two hours after eating, it was normal. When I told the doctor the story, she recommended random blood sugar checks.
On April 17, my dad checked my son’s blood sugar (his finger was cleaned with alcohol) because he had been peeing a lot. It was about 30 minutes after he ate and it read 370 mg/dl [20.6 mmol/L]. He checked it again about an hour later and it was 490 mg/dl [27.2 mmol/L]. He had eaten pancakes without syrup but with sugar in the batter. I had to pick him up from my dad’s and, by the time I got him to the hospital, his blood sugar was 89 mg/dl [4.9 mmol/L], two hours after eating. They did blood work and everything was normal. His A1c was 5.0; C-Peptide was 1.2; Insulin Antibody, Islet Cell Antibodies, and Anti-GAD Antibodies all were normal (I don’t have the specific results); CO2 was 21; acetone serum was negative and urine ketones were negative.
We saw an endocrinologist last Thursday and she thinks he may have MODY.
Since April 17 until his appointment with the endocrinologist on April 31, we had him on a “diet” – no sugars, more vegetables, and, if he ate breads or pastas, it was wheat. During this time, all his reading were fine. The doctor has told us to allow him to have anything to eat for two weeks then to put him back on his “diet” for two weeks. We are checking his blood sugar about four or five times a day.
Answer:
Those were definitely abnormal glucose readings. The laboratory results you reported are normal, but not all people with type 1 diabetes have antibodies. You sound like you need more specific diet advice especially about the glycemic index. Stay in touch with your endocrinologist and especially report enuresis, change in weight, thirst, urination OR persistent hyperglycemia.
SB
