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October 16, 2002

Diagnosis and Symptoms

Question from Shelburne, Nova Scotia, Canada:

My nine year old son is very thirsty, always hungry, and you can never satisfy his hunger, but is a very small child (around 62 pounds). People kept telling me to check him for diabetes, and since I had my own monitor, checked him one day after supper, and he was 10.9 mmol/L [196 mg/dl]. This got my attention, so I then began to monitor him quite frequently and realized his blood sugar was rising a lot after meals. He could go as high as 18 mmol/L [324 mg/dl], but this is usually within an hour after eating, and his morning readings were still normal. I had the two-hour glucose test done on him at the hospital, and since it was normal, my doctor told me there was no way his blood could be going that high. So I took my monitor to a nurse who calibrated it and said it was fine. After four months of still monitoring my son (by my meter), his morning readings are now going up to 10.7 mmol/L [192 mg/dl], and I know this is really high for morning readings. It has gotten worse over time, and he goes over 11.0 mmol/L [198 mg/dl] every day -- even an orange will put him above normal range. The doctor said he does not have diabetes, but I am very confused and concerned about my son. I can even tell when his blood is high now, because his cheeks get really red. However, I am scared to go back to the doctor because it could be normal again. I check my son as soon as he wakes up in the morning, (before he steps out of bed) is this okay? After eating or drinking something, if he does not have diabetes, should his blood be always going over 11.0 mmol/L [198 mg/dl] within 20-40 minutes and then start lowering? I feel the doctor does not believe me and that really bothers me. Could you give me a second opinion on this, I really need your advice. What could be wrong?

Answer:

Please take him to the doctor. If he is having blood sugars as high as you indicate, it may be appropriate to consider starting treatment. I would not delay in getting him evaluated.

JTL
Additional comments from Dr. John Schulga:
It does sound as though your child’s blood glucose readings with your meter
are at times higher than they should be. If you are checking his readings
correctly, and you are washing his hands carefully, I would suggest you go
back to the doctor and have things reassessed. One test that may be of use
are autoantibodies, such as
islet cell antibodies and GAD antibodies. It would be worth asking your doctor about these tests.

JS