May 16, 2006
Diagnosis and Symptoms, Honeymoon
Question from Greenfield, Ohio, USA:
About six months ago, we started noticing symptoms of diabetes in our then five year old daughter. Her glucose tolerance test showed a blood sugar of 325 mg/dl [18.1 mmol/L] at one hour but only 156 mg/dl [8.7 mmol/L] at two hours. About 80% of her fasting blood sugars are 90 to 110 mg/dl [4.4 to 6.1 mmol/L], with the rest running from 110 to 200 mg/dl [6.1 to 11.1 mmol/L] I have diabetes, along with my brother and his only son, all of us being diagnosed before puberty.
No one will tell us what is going on with our daughter. They tell us to monitor her but not to restrict her carbohydrate intake, although we do because too much makes her feel horrible. We cannot get a straight answer and are assuming she is in the honeymoon stages of diabetes. Are we correct? If so, how long can we expect this to last? Everyone in my family was diagnosed after extremely high sugars, so this is something new for us. Any information would be greatly appreciated.
Answer:
It sounds like the earliest stage of diabetes that you have detected with judicious attention to her symptoms and testing. I would suggest that you discuss your concerns directly with the diabetes team with whom you are working; if not, then schedule an appointment so that you can get their advice. It has always seemed reasonable for me to suggest carbohydrate restrictions under such circumstances since it often works and obviously allows less insulin needed to provide energy, growth, etc. Less stress on the damaged pancreas may also be helpful. It would be nice to know about insulin, islet and GAD65 antibodies since these are often, but not always, positive early in diabetes. Frequent monitoring is often also helpful to document whether things are changing or not with the blood glucose levels. This is especially important with any illness or growth spurt.
SB
