Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
February 15, 2005
Diagnosis and Symptoms
Question from Sevierville, Tennessee, USA:
My two year old daughter has been showing some of the symptoms of type 1 diabetes. She has been drinking a lot, including an eight ounce cup within minutes and then want more. She has been wetting more excessively and her urine has a strange, strong odor to it. She has lost about four pounds, yet her eating hasn't changed. If anything, she eats better. My cousin, who has a child with type 1 diabetes, checked her level and it was 236 mg/dl [13.1 mmol/L]. She rechecked and it was 233 mg/dl [12.9 mmol/L]. I took her to the doctor the next morning. They did a glucose only test and it was 78 mg/dl [4.3 mmol/L]. They told me to feed her and recheck. Her blood sugar was then 98 mg/dl [5.4 mmol/L]. I was sent home and told not to worry. I asked them to send me home with a Freestyle kit. I did a test and it was 142 mg/dl [7.9 mmol/L]. The next morning, I did an eight hour fasting test and it was 78 mg/dl [4.3 mmol/L]. I am concerned, but the doctor does not seem to be. Could she be in the beginning stages of type 1 diabetes? Could this be the honeymoon period? Is there anything else that would cause her levels to go up and down like that?
I would probably be a little more aggressive given this history and the discordant values and consider doing pancreatic antibody testing (ICA512, GAD 65, insulin autoantibodies) and/or even consider doing a properly performed oral glucose tolerance test. The test differs for pregnant women than for most everybody else. Specifically:
In the days leading up to the test, at least 60% of the calories consumed should be carbohydrates.
The glucose load is very specific: 1.75 grams per kilogram that the child weighs, to a MAXIMUM of 75 grams.
VENAPUNCTURE glucose and insulin, done by a laboratory, not on a glucometer, should be done at the beginning, 30 minutes, 60 minutes and two hours.
If the doctor’s office also used a glucometer to screen your child, do you/they know the last time it was calibrated, controlled, checked, etc.? Glucometer readings can screen for glucose but they should not be used to make a diagnosis.