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March 6, 2010

Diagnosis and Symptoms

Question from Scottdale, Pennsylvania, USA:

My nine-year-old son has had a few slightly elevated 12 to 14 hour fasting glucose results. They have ranged from 96 mg/dl [5.3 mmol/L] to 134 mg/dl [7.4 mmol/L], with the most recent one being 115 mg/dl [6.4 mmol/L]. My sister and I both have type 1. She was diagnosed with it approximately two months after having pneumonia. I was diagnosed with it about two months later. My son had the swine flu in November and now, in February, has had the slightly elevated fasting glucose levels. I am concerned that he is on the verge of being diagnosed with diabetes. I went through a "honeymoon stage" for a while during the first year to two years after my diagnosis. Diabetes is abundant on my side of the family, plus it is on his father's side of the family. Do I have cause for concern or am I just being overly concerned?

Answer:

I think that your concerns are thoughtful. I don’t know that your son has diabetes mellitus but he is at risk, given the family history you presented.

I would be interested to know how old you and your sister were when you were diagnosed with type 1 diabetes. Do either of your parents have diabetes? There are strongly inherited forms of diabetes, referred to previously as “Maturity Onset Diabetes of the Young (MODY)” and now known as Monogenic Diabetes. The inheritance pattern is such that it is passed from one generation to the next. It often is confused with “plain old” type 1 diabetes, although it is much less common. MODY can often be treated without insulin.

A diabetes honeymoon that lasts one to two years, such as you experienced, is pretty common with typical – but nicely controlled – type 1 diabetes.

You should consider participating in TrialNet, a national study looking at families with diabetes and those who are at high risk. One of the ultimate purposes of TrialNet is to prevent type 1 diabetes at those at high risk. Your son could be tested at no cost!

DS