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August 16, 2008

Diagnosis and Symptoms, Hyperglycemia and DKA

Question from Plano, Texas, USA:

My daughter has frequent high blood sugars 150 mg/dl [8.3 mmol/L] to 250 mg/dl [13.9 mmol/L]. I was checking her several times a day and monitoring her sugar and carbohydrates and was keeping it around 100 mg/dl [5.6 mmol/L]. I took her to the doctor and he said she does not have diabetes but can not rule out pre-diabetes. Her fasting blood sugar was 110 mg/dl [6.1 mmol/L], which he said was questionable. Her A1c was 5, which he said was good. He gave me no plan and said he would not continue to restrict her diet or continue checking her unless she started showing more signs. I researched pre-diabetes and that is for overweight kids. My daughter is three and 30 pounds, not overweight. So, I stopped checking her but, "just because," I checker her again the other day and she was 200 mg/dl [11.1 mmol/L]. That night, before bed, she was 150 mg/dl [8.3 mmol/L]. Her sugar is high for not having diabetes. What should I do? Should I wait three months until her A1c goes up or continue to restrict her diet on my own and monitor her myself? If so, what should my goal be? And, how often should I check her? We have had blood sugars as high as 350 mg/dl [19.4 mmol/L].

Answer:

Sorry to disagree with your doctor, but these blood glucose values are definitely abnormal and definitely consistent with a diagnosis of diabetes. I would suggest that you contact a pediatric diabetes specialist in the area for a consultation as soon as one can be arranged and that you continue to monitor blood glucose levels. If she loses weight, has more urination, enuresis or has other problems, you should consider calling your primary care physician or visit the emergency room to be sure she does not have decompensated diabetes situation called diabetic ketoacidosis (DKA).

SB