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June 24, 2006

Diagnosis and Symptoms

Question from Temple, Georgia, USA:

Both my brother and sister have type 1, so, periodically I check my eight year old son's blood sugar. Over the last year, it has been up and down, ranging from about 90 to 130 mg/dl [5.0 to 7.2 mmol/L]. Since he had no other symptoms, I wasn't worried. Last week, I started noticing that he wants to take frequent naps, which is NOT something he normally does. I can't tell if he is unusually thirsty because he has always been a big drinker. He may have lost some weight, but I'm not sure. At the doctor's office about a month ago, he weighed 58 pounds. I weighed him at home yesterday and he weighed 55 pounds. That could just be the difference in the scales. Yesterday, I decided to take his blood sugar, just in case. It was 163 mg/dl [3.5 mmol/L]. He hadn't eaten anything in about three hours. He played outside for about an hour and it came down to 132 mg/dl [7.3 mmol/L]. His fasting blood sugar this morning was 91 mg/dl [5.1 mmol/L]. What do you think about this? Could this be an early sign of type 1?


You have a single very high blood glucose reading that is not normal. I would do what I call a blood glucose profile for three days in a row. Test just prior to breakfast, lunch and dinner plus one to two hours after each of these meals. The normal values should be less than 100 mg/dl [5.6 mmol/L] before eating and less than 140 mg/dl [7.8 mmol/L] (some would say less than 126 mg/dl [7.0 mmol/L]) afterwards. If this occurs, then he is probably making sufficient insulin. Make sure that your technique is correct and that there is no food or alcohol on the finger site that might interfere with the test results. If you are still worried, then consult with your physician and consider consultation with a pediatric endocrinologist for islet cell and GAD-65 antibody testing, etc. The actual risks for someone with both an aunt and uncle with type 1 diabetes are probably less than 5%, but for any individual, the specific risks are not truly known.