August 15, 2002
Diagnosis and Symptoms
Question from Huntington, West Virginia, USA:
My five year old son’s father has type 1 diabetes, and approximately six months ago, my son had an episode one morning. He was sleeping and was very clammy and thrashing around in bed. I tried to wake him, but could not get him fully conscious. He would open his eyes but you could tell he just wasn’t all there. He would groan and hold his stomach. I assumed he was coming down with a stomach virus, so I just held him and waited. About an hour later, it occurred to me to check his sugar.which was 60 mg/dl [3.3 mmol/L]. I gave him a 12 ounce glass of juice which he chugged and wanted more. I gave him another glass, fed him a sandwich, and he then was completely fine.
I called the family physician who told me to start checking his sugars every so often just to see what happened. That evening I checked it, and it was 199 mg/dl [11.1 mmol/L]. However, it came down pretty quickly with no intervention. Over the next few weeks his sugar was pretty out of whack but never reached 200 mg/dl [11.1 mmol/L] again. They did the antibody test on him and said it was fine.
His sugar level has been completely normal until about two weeks ago, when it started going up again. It doesn’t happen on a consistent basis, and it seems to go down fairly quickly after it peaks. Our physician said he believes his pancreas is “sputtering” and will eventually give out altogether. However, all he could tell me to do is go home and wait. Do you agree? Could this be a precursor to diabetes? If these are early symptoms, how long do you think until it goes full blown? I feel like we’re playing Russian roulette just waiting for it to happen.
Answer:
This sounds very unusual and certainly is not normal. Blood glucose readings in the high 100s [mg/dl, 5.6 mmol/L] are definitely not normal and suggest insulin deficiency. However, this does not explain the unusual episode that you witnessed which sounds like hypoglycemia.
You should either be in touch with your husband’s endocrinologist or consult with a pediatric diabetes specialist who can do a more detailed evaluation. Not all antibody tests are equally sensitive so we usually use a combination of several tests. Even when several are utilized, however, antibody levels can be negative about 20-30% of the time even when diabetes is going to occur.
Doing a profile of pre and postprandial blood glucose tests for several days would give you an idea of what is happening at this time. If symptoms persist or are changing, then you should get in touch with your son’s physicians so that he does not get sick if diabetes is going to develop.
SB
