December 4, 2003
Diagnosis and Symptoms
Question from Dublin, Ireland:
My 5-year old niece was admitted to hospital with suspected diabetes. They run several tests and the only thing that we heard was that “her level is 31 [558 mg/dl] while it is supposed to be 6-8 [108-144 mg/dl]”. I presume they were talking about the blood sugar level. Can a person get diabetes, with no family history of diabetes and how is that possible? As I have a 6-month old baby and I am concerned for her well-being.
A blood sugar of 31 mmol/L or 558 mg/dl in a 5 year old is almost certainly due to some form of diabetes, most probably Type 1A or Autoimmune Diabetes. In this condition a disorder of the immune system slowly; but progressively destroys the insulin producing cells in the pancreas. There are two main underlying factors which lead to the disorder. One is genetic to which a variety of paternal and maternal genes contribute; but the other, which is probably the main reason for the usually absent family history, is a number of environmental factors. This was realised many years ago from the discordant incidence of this form of diabetes in identical twins. These environmental factors are not yet identified despite vigorous research. For a number of years early exposure to cow’s milk was thought to be important; but this is no longer accepted, a number of viruses especially Coxsackie viruses were also thought to have a role; but again this has not been confirmed. I hope this helps to explain the family history story.