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July 12, 2006

Diagnosis and Symptoms

Question from London, United Kingdom:

My six year old daughter has a congenital disability causing head, neck, back pain, and deafness. She has never been overweight. Recently, she has dramatically lost weight, which was confirmed at her recent appointment with her neurologist. She is eating very well. I don't know if she's drinking excessively because she gets her own drinks. She has been complaining about stomach pains for a few weeks now. At my request, the hospital performed a blood glucose test about four and a half hours after eating. The result was 4.3 mmol/L [77 mg/dl]. My father had type 1 diabetes and my mother has type 2. My father used his blood glucose monitor and tested my daughter's blood about 15 minutes after eating and it was 9.4 mmol/L [170 mg/dl]. My mother's blood sugar, at the same time, after eating the same food, was 7.6 mmol/L [137 mg/dl]. Should I be concerned? My parents are. My daughter looks very poorly and is very thin now.

Answer:

An isolated blood glucose elevation is cause for questions and ongoing testing. This certainly could be the beginning of diabetes from insulin deficiency. You did not mention a specific diagnosis for these problems, but there are certain conditions where diabetes is more common. So, I would continue to monitoring her blood glucose at home several times each day for the next week and then present this information to your physicians to review. A normal blood glucose is less than 100 mg/dl [5.6 mmol/L] preprandially and less than 126 mg/dl [7.0 mmol/L] postprandially. If there were still some questions, pancreatic antibodies could be measured as can hemoglobin A1c, but these are not always so helpful in early diagnosis. Also, you should consider consulting with a pediatric diabetologist if there is still some abnormality on close blood glucose testing.

SB