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July 17, 2003

Diagnosis and Symptoms

Question from Claremont, North Carolina, USA:

My seven year old daughter has suspected diabetes, and had glucose readings ranging between 129-172 mg/dl [7.2-9.6 mmol/L] after meals for the past two weeks. Her pediatrician said that she needed to be checked only if her fasting readings were over 110 mg/dl [6.1 mmol/L], and they are 72-101 mg/dl [4-5.6 mmol/L]. Do I go by the fasting or the after meals levels?If my daughter's fasting levels are normal but her after eating levels are somewhat high, should I be concerned?

Answer:

It sounds like your daughter has some abnormal postprandial readings and could be in the early stages of diabetes. You may want to get antibody testing done (islet cell antibodies and GAD antibodies). If positive, it would indicate already present autoimmune problems in the pancreas, for instance. You also may want to check lipid levels.

If your daughter is overweight, this could merely be the beginning of insulin resistance/insulin deficiency. If not overweight, it could be the beginning of type 1A (autoimmune) diabetes.

If there’s still a question, you may want to consult with a pediatric diabetologist in your area. Cutting back on simple sugar intake may be helpful to slow down the process, but unfortunately there really is not very much clinically that can be done except to monitor and make sure that she does not become dehydrated, need hospitalization, etc. if you are just documenting the demise of the beta cells.

SB