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October 18, 2002

Diagnosis and Symptoms

Question from Wilkesboro, North Carolina, USA:

My five year old, who weighs 55 pounds and stands about 42 inches tall, has the majority of the symptoms of diabetes, so I monitor him frequently. After fasting for nine hours, it runs 146-160 mg/dl [8.1-8.9 mmol/L]. Usually, after a light meal, his blood sugar rises to over 292 mg/dl [16.2 mmol/L]. About five months ago, he was hospitalized for five days because he was nearly unconscious and had no control of his body functions, but they said there was nothing wrong with him. Do you think my son may have diabetes?

Answer:

Obviously, I do not know the details of your child’s illness earlier this year. I doubt that your doctor said that there was “nothing wrong with him” given that he was unconscious and lost control of bodily functions, as you describe. Maybe what they actually said was that they could not find what the cause of the problem was. That is very different! Very often, the most correct treatment depends on the most precise diagnosis, and it sometimes is hard to treat something when you don’t know what is happening.

As for the glucose levels you’ve recorded, why are you measuring the blood glucose? Where did you get the machine? Have you calibrated it and checked control solutions, etc.? These are some of the issues surrounding why a diagnosis of diabetes cannot be established simply with a glucose meter. Once a diagnosis is established, the glucose meters are very helpful. However, there is no doubt: the levels you report are consistent with diabetes, and your child should have the diagnosis confirmed.

You should relay your information to his pediatrician who may likely request a fasting blood glucose measured from a vein in the hospital laboratory and perhaps a sample after a hearty breakfast. The doctor may even request a test that is used to assess the blood glucose over the prior weeks, or perhaps they will refer you to a pediatric endocrinology specialist.

I do not know if diabetes explains your child’s issues five months ago, as it would have been easy to have found diabetes then if present. The measurements you provide would suggest that he is stocky for age but not short.

DS