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September 26, 2003

Research: Causes and Prevention

Question from Canada:

My two year old daughter had one blood sugar reading of 13 mmol/L [234 mg/dl], but she has not been high since. We are not convinced she has diabetes, but there seems to be no other explanation at this point. The doctor said if she becomes ill, the progression of the disease may quicken. She is supposed to start preschool, and we were wondering if you think that exposure to so many new children and their illnesses may cause her to develop diabetes more quickly. Is it possible that protecting her from early exposure to a lot of viruses will either prevent or delay the onset of type 1 diabetes?

Answer:

A single reading of 13 mmol/L [234 mg/dl] in a two year old is not diagnostic of diabetes, especially if it was obtained on a home blood glucose monitor, non-fasting, and in a setting where there was anxiety over the possible diagnosis for some reason. Even in a clinical laboratory or a doctor’s office, the unfamiliar aura of white coats, needles and an anxious mother would be enough to produce this result as a stress response.

If there are any corroborative symptoms of diabetes, you might talk to the doctor about getting antibody testing which would go a long way to confirming or corroborating type 1A (autoimmune) diabetes in a Caucasian family. A less expensive alternative is to have a very experienced nurse take a fasting blood sample using a ‘butterfly’ needle or, if available, a meter that allows Alternate Site Testing.

Exposure to intercurrent infections might hasten insulin dependence if the autoimmune process had already started, but the evidence to date from a national Study (DAISY) is that it does not initiate it.

DOB