My three and a half year old son was diagnosed with type 1 diabetes one week ago. His pediatrician found ketones in his urine and sent us straight to the children’s hospital. His blood sugar was 191 mg/dl [10.6 mmol/L] at the hospital at admission. The highest it’s gone this week is 264 mg/dl [14.7 mmol/L] and the lowest has been 56 mg/dl [3.1 mmol/L] (in the middle of the night). We test five times and day and give small amounts of insulin two times a day. His numbers change a lot. We may be in denial, but we do not feel like he has diabetes. Overall, he is a healthy, active child. He does have frequent sinus infections and is on antibiotics for this a lot. Could the infections be making the changes in his blood sugar levels and not diabetes?

Please accept this answer with the sincerity and the touch of humor with which it is sent.

In response to your question, “YES! You are in denial.”

Let’s objectively look at the facts as available: Elevated glucose? Check. Presence of ketones with elevated glucose? Check. Requiring insulin? Check.

I presume that there was a REASON that the glucose level and urine ketones were measured, such as symptoms of change in urinary and thirst habits. Where does NOT having diabetes come in?

It is TERRIFIC that the child is generally well! That’s good. Please don’t test to see how “well” he will be if you withhold insulin.

Yes, “stress” and “infections” can affect your blood sugar. But, in people with a normally responsive pancreas, you don’t get the combination of things above. By all means, I have often said that just as “not all that glitters is gold, not all that is hyperglycemia is diabetes. But, it usually is.”

A toddler/pre-schooler typically does not require a lot of insulin. Of course, that child is much smaller than a 6, 13, 18, 22, 40 year old.

Please vent your concerns with your Diabetes Team. They may (or may already have) perform special pancreatic antibody testing to measure the immune proteins that commonly, but not always, are present in type 1 diabetes.

DS