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March 6, 2003

Diagnosis and Symptoms

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Question from Lake in the Hills, Illinois, USA:

In retrospect, my three year old daughter, diagnosed with diabetes at the age of 15 months, began to show signs three months prior to diagnosis, and my 15 month old son is beginning to show the same signs (excessive thirst, soaked diapers, sleeping more, irritable). We have been testing his blood sugar randomly, and he has had readings of 130-260 mg/dl [7.2-14.4 mmol/L].

When he was 260 mg/dl [14.4 mmol/L], I called his pediatrician who said to take him to the ER where his blood sugar was 100 mg/dl [5.6 mmol/L] three to four hours afterward. All blood work was within normal range, and his urine showed no sugar or ketones. I have not received his A1c yet. The ER doc said that if his blood sugar comes down on its own, my son does not have diabetes. What can explain his symptoms and his high blood sugar?

Answer:

From: DTeam Staff

Not all elevations in blood glucose equal a diagnosis of diabetes mellitus. Nevertheless, the advice you were given that if the glucose level came down by itself that it is not diabetes, is not entirely correct.

At age 15 months, the pancreatic antibody tests may not be helpful but ask your son’s doctor to consider requesting the GAD 65, ICA 512, and insulin antibody blood tests, but be sure they go to a proper endocrine specialty reference lab.

I think it is hard to ignore your son’s symptoms and blood glucose readings. You may wish to ask for a referral to a pediatric endocrinologist for your daughter and your son. There should be several options at any of the larger metropolitan areas within your state (or even across the state line) where there are either medical schools or children’s hospitals.

DS