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July 16, 2008

Diagnosis and Symptoms

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Question from Cairo, Egypt:

Six months ago, my 10-year-old son was found to have high blood sugar. His doctor performed a glucose tolerance test and C-Peptide test. Two hours after he consumed 75 grams of glucose, my son’s blood sugar was 290 mg/dl [16.1 mmol/L]. The pediatrician said it was not type 1 because his C-Peptide was 1, which was high for type 1. She prescribed Glucophage tablets, 500 mg, one-half a tablet daily with no food restrictions.

Over the months, my son’s blood sugar has been normal except for a few days. A month ago, he had another glucose tolerance test. This time, the doctor said that my son should get 1.75 grams of glucose for the test, that he had been given a higher amount during the initial test. So, this time, after two hours, my son’s blood sugar was 137 mg/dl [7.6 mmol/L]. Based on this, my son is pre-diabetic. And, over the past three weeks, his blood sugars have been normal except for the three or four times they were high, but we gave him no treatment. Neither myself nor my wife have diabetes. What kind of diabetes might our son have?

Answer:

From: DTeam Staff

Making a diagnosis of diabetes can occasionally be a little tricky when a child doesn’t have clear symptoms of diabetes. This can be especially tricky when a physician is assessing a child’s risk for developing type 2 diabetes and may have had a history of an occasional high blood sugar. Your child would benefit from a thorough review of his history and a complete physical examination as well as a review of any testing that may be done. Your pediatrician will then be able to best assess his risk for developing diabetes. It looks to me like he had a clearly positive test for diabetes when his blood sugar was 290 mg/dl [16.1 mmol/L] on his original glucose tolerance testing, while his repeat glucose tolerance testing looks normal to me. For a thorough discussion of how to interpret glucose tolerance testing, please see our page on the Classification and Diagnosis of Diabetes.

MSB