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February 26, 2008

Diagnosis and Symptoms

Question from Canada:

I was just wondering what is going on with my daughter. I have type 1 diabetes and checked my daughter one night as she has started getting some symptoms of diabetes. Through further testing, I don't think she does have it as she also gets lows, but I just wanted to make sure. So far this week, she was 3.4 mmol/L [61 mg/dl] with 0.7 blood ketones (checked the ketones twice). Two and a half hours later, after the consumption of 15 grams of carbohydrates (sweet potato, beans and tomatoes), she was 9.7 mmol/L [175 mg/dl]. Her fasting/morning blood sugars are upper 4s mmol/L [81 to 89 mg/dl]. Except for today, her pre-lunch blood sugars are in the 6 mmol/L [108 mg/dl] to 7 mmol/L [126 mg/dl] range, while her pre-dinner blood sugars are in the 6.5 mmol/L [117 mg/d] to 7.5 mmol/L [135 mg/dl] range. Today, she was 3.7 mmol/L [67 mg/dl] prior to lunch, which was 25 grams of carbohydrates (a sandwich with cheese), but 10.4 mmol/L [187 mg/dl] two and a half hours later. Her blood ketones were 0.4. These slightly higher readings are when she seems to be quite thirsty, too. So, what do you think is going on? Is it possible she is in the early stages of diabetes or does she have some kind of hypoglycemia?

Answer:

She could be in the early stages of diabetes. Sometimes hypoglycemia occurs as the beta cells are “dying out.” I would suggest that you discuss this with a pediatric diabetes specialist in your area. If none are available, then perhaps with your own diabetes team, and they can refer you. If there is any weight loss, enuresis, blurry vision, excess urination and/or excess thirst, then go to the emergency room. Antibody testing may also be helpful to see if there are any positive antibodies as a forerunner to frank diabetes.

SB