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October 19, 2000

Diagnosis and Symptoms

Question from Idaho Falls, Idaho, USA:

My husband has had type�1 diabetes for over 20 years. We knew that our children have a somewhat elevated risk of developing diabetes as well. Our two year old has been drinking pop (we only have diet) like crazy, refusing his rice milk (allergic to regular milk), is cranky as heck, and has fruity breath. I tested his fasting blood sugar on my husband’s meter, and got a 173 mg/dl [9.6 mmol/L], and then a 160 mg/dl [8.9 mmol/L] an hour later. Previous questions in this column say that a home meter should never be used to diagnose diabetes, even though our community health fairs always use them to screen for diabetes. I hate to take him to the doctor when it isn’t necessary, but I’d also rather take him when his diabetes is new, and not when he goes into a coma with an 800 mg/dl [44.4 mmol/L]. What are your thoughts?


From: DTeam Staff

I think that your small son is already in mild ketoacidosis and needs to be seen by his doctor right away (if necessary, in the Emergency Room). His fasting blood sugar is significantly abnormal, and the fruity breath is almost certainly acetone.

It is true that glucose monitors are subject to error when used casually by the untrained.

Additional comments from Stephanie Schwartz, diabetes nurse specialist:

A meter should never be used for diagnostic purposes. When screenings are done they are just that: screenings. If the person has an elevated blood glucose level on the meter, he or she in then referred a physician for further testing and diagnosis.

Since your son is symptomatic and appears to have elevated blood glucose levels, he needs to be seen by his doctor right away, as Dr. O’Brien has suggested.