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April 4, 2007

Diagnosis and Symptoms

Question from Ventura, California, USA:

My 10-year-old Caucasian daughter was diagnosed just last week with type 1. We discovered this when I took her into the pediatrician with a possible UTI. While testing her urine, he discovered ketones and a high glucose amount, causing him to test her blood glucose which measured at 223 mg/dl [12.4 mmol/L]. Two hours later, we took her hours to the endocrinologist where her blood glucose was 187 mg/dl [10.4 mmol/L]. He gave her insulin and sent me home with the "supplies." Her blood glucose has been normal every since and she has been receiving four units of long-acting insulin at night. Today, the endocrinologist got the blood results back. He said my daughter's three month blood average was normal and she tested negative for antibodies. He is having me reduce her nightly insulin gradually to see if she can remain stable, even with no insulin. He has never seen this in a Caucasian child. Is it possible she doesn't have diabetes? Could the UTI have been the source of her high glucose? Do I need to be watching for anything else? My daughter has a history of UTIs, gum inflammation, and severe lip chapping. I had noticed a weight loss in the past six months.


This sounds rather odd. Antibodies are only positive about 60 to 80% of the time, so negative antibodies are not so helpful while positive antibodies “clinch” the diagnosis. This can happen in Caucasians as well as others. Time will help sort this out. It is most important to do frequent blood glucose checks so that assumptions about glucose levels are not assumptions but reality. Stay in close touch with your endocrinologist since they would know the situation more specifically. This does not sound like any of the other conditions you mention would cause such high sugar levels, but an early pancreas problem with insulin deficiency sometimes acts just like this depending upon which phase it has been “diagnosed.”


[Editor’s comment: See also our previous questions on the diabetes Honeymoon and the Diagnosis and Symptoms of diabetes.