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March 25, 2005

Diagnosis and Symptoms, Insulin

Question from Cheektowaga, New York, USA:

When my son was having surgery to repair his kidney reflux, the doctors found sugar in his urine. His blood glucose was 198 mg/dl [11.0 mmol/L] and his A1c was 7.9. His blood sugars were then found to be in the normal range and his A1c was 5.9. In the winter, his blood sugars are higher. The doctors are not sure what my son has, but are convinced that he needs to go on insulin. I don't understand why his blood sugars are normal in the summer, yet high in the winter.

Answer:

A blood glucose of 198 mg/dl [11.0 mmol/L] is definitely abnormal. An A1c of 7.9% is also definitely abnormal. I do not understand exactly what your question is. It would be wise to go back and speak to the child’s diabetes team and ask specific questions. Antibody levels may help answer, but only if positive. If negative, this will not be helpful since 20 to 40% of kids have negative antibodies even though they still have autoimmune type 1 diabetes. If dietary changes alone do not normalize the blood glucose levels, then it is likely he will require insulin.

SB