April 8, 2003
Diagnosis and Symptoms
Question from Chicago, Illinois, USA:
About 10 months ago, my six and a half year old daughter had recurrent yeast infections that led to a urine test that showed glucose and then a random finger prick blood glucose of 225 mg/dl [12.5 mmol/L]. I pushed for a referral to an endocrinologist who did an oral glucose tolerance test that showed she had impaired glucose tolerance (her two hour reading was 186 mg/dl [10.3 mmol/L], but she had a normal fasting blood glucose the next day).
Now we check my daughter’s blood glucoses whenever she seems to be experiencing a low, and whenever she has a yeast infection or vaginal odor. For the most part, her fasting and bedtime readings are normal, but once every few weeks her bedtime levels are 250-260 mg/dl [13.9-14.4 mmol/L]. She has no other symptoms so I am wondering what the next step should be. Should we continue monitoring? Should she have another GTT? Should we stop everything and look for developing symptoms?
Answer:
Your daughter’s endocrinologist should be investigating her glucose tolerance a little further. You can’t make a diagnosis based upon capillary blood glucose values. She should consider the monogenic forms of diabetes (e.g. glucokinase deficiency). This is important because the latter condition requires no treatment, and there are genetic tests available.
KJR
