May 25, 2003
Diagnosis and Symptoms
Question from Phoenix, Arizona, USA:
Since age four, my 13 year old daughter has been more or less a “carbo junkie” even to the point of preferring to go hungry rather than eating protein or veggies. She has also been prone to violent mood swings and has been known to “melt down” over the least thing. She has had dry brittle hair for years and extremely dry skin. She was recently hospitalized due to extreme constipation. They cleaned her out, did blood work, and her fasting glucose was 135 mg/dl [7.5 mmol/L]. She also had a high triglyceride level about 15 months ago.
My father had type�2 diabetes and became insulin dependent before his death, and I had elevated gestational diabetes with my daughter. My understanding from what I know of my father’s diabetes is that elevated href=”/dctionary/t.htm#triglycerides”>triglycerides which I understand can be precursory to and indicative of diabetes. What other questions should I be asking her pediatrician? I have voiced strong concern over her dietary habits for years, but have always been met with “she’s growing, don’t worry”, even though the family history is in her chart.
Answer:
Certainly the glucose reading of 135 mg/dl [7.5 mmol/L] is suggestive of diabetes. However, in light of the circumstances, (being purged for the constipation), I’m not certain that a single blood value is perfectly diagnostic. I presume that it was a sample via a vein stick and not simply a “fingerstick” on a meter. The latter is not diagnostic of diabetes. The other symptoms that you describe are also interesting, possibly worrisome, but not definitive for any diagnosis. I don’t believe that you indicated your child’s height and weight.
Your issues should be addressed and a formal, full history and physical should be scheduled so that your pediatrician can assess for glucose problems or thyroid problems, or nutritional issues. Ask his/her office staff to schedule your daughter for a full, complete visit and not simply a fast “problem oriented” visit.
DS
