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January 1, 2008

Diagnosis and Symptoms

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Question from Lucas, Texas, USA:

After my diagnosis of type 2 diabetes, my five-year-old daughter became interested in checking her blood sugar. I checked her fasting blood sugar one morning and it was 136 mg/dl [7.5 mmol/L]. Slightly concerned, I then randomly checked her blood sugar over the next week, including her fasting blood sugar. Her fasting has always been between 96 mg/dl [5.3 mmol/L] and 105 mg/dl [5.8 mmol/L]. Her random numbers, one and half to two hours after eating were 204 mg/dl [11.3 mmol/L] to 238 mg/dl [13.1 mmol/L]. After seeing these numbers for a few days, I scheduled a doctor’s appointment. Her doctor’s appointment was on Friday, December 21. Her pediatrician suggested a random blood sugar and A1c, as well as a urinalysis. I have not heard back on these test from the doctor’s office because of the holidays. I did not check her blood sugar’s over the weekend, but resumed on Monday. Since Monday, her numbers have been perfectly normal. She has still been around 96 mg/dl [5.3 mmol/L] fasting, but not over 100 mg/dl [5.6 mmol/L]. Her pre-meal levels have been between 85 mg/dl [4.7 mmol/L] and 90 mg/dl [5.0 mmol/L]. Her post meal numbers have been no higher than 120 mg/dl [6.7 mmol/L].

I really have no idea what is going on with my daughter. She has classic symptoms of diabetes. She has always been on the skinny side, she is always thirsty, and she still wears pull-ups at night. She has weekly accidents. She also has poor eyesight and wears glasses. I would have just assumed her tests would show her to be diabetic, until this week, according to her previous numbers. I am confident with my testing ability and I had my meter tested about two weeks ago at my own appointment. Could this be diabetes caught very early? Or, am I just an overprotective mother?

Answer:

From: DTeam Staff

Most meters and bottles of strips give a range for the control solutions. Patients are often amazed at the range for low, normal and high controls. That is the problem with diagnosing diabetes with a home meter. Diabetes is a laboratory fasting glucose of 126 mg/dl [7.0 mmol/L] on two occasions. Over 200 mg/dl [11.1 mmol/L] with symptoms is also diabetes, if the blood sugar has been determined by a laboratory. Of course, I diagnose diabetes with 400s mg/dl [over 22.2 mmol/L] and symptoms right out of the doctor’s office. The weight loss and the bed wetting, etc. help, too.

Sometimes it is hard to know. You might ask for some of the antibodies (GAD-65, IAA, ICA) to be tested. Since you have a five-year-old, are you sure you don’t have type 1, too? Again, it is antibodies testing that can help with diagnosis.

Right now, I don’t see how you can diagnose diabetes, but do look for symptoms, including thirst and increased urine and you won’t miss it. You also won’t have to prick her finger several times a day either.

LD