August 28, 2002
Diagnosis and Symptoms
Question from Forest, Virginia, USA:
About three weeks ago, my four year old daughter had a glucose level over 300 mg/dl [16.7 mmol/L] after breakfast during a physical so her doctor requested she return the next day for fasting level which was 92 mg/dl [5.1 mmol/L]. Since then, she has had two readings over 300 mg/dl [16.7 mmol/L], three over 200 mg/dl [11.1 mmol/L], and some days her levels will be anywhere from 61-230 mg/dl [3.4-12.8 mmol/L]. Each morning, her fasting level is 90-116 mg/dl [5-6.2 mmol/L], and at night her readings have consistently been 80-130 mg/dl [4.4-7.2 mmol/L].
The doctors are telling me that this is the onset of type 1 diabetes, but everyone I talk to has told me that their diabetes started all at once and they were very sick. My daughter has not lost any weight and is not urinating or drinking excessively. Her A1c was 6.7% and other tests are forthcoming. I am looking for someone with more experience than I to talk to since this is all new for me and my family.
Answer:
Random blood glucose levels of 300 mg/dl [16.7 mmol/L] are never normal. This is type 1 diabetes. Be grateful that your daughter didn’t go to the ICU and become critically ill.
A hemoglobin A1c of 6.7% and represents an average glucose of over 140 mg/dl [7.8 mmol/L] if the test is standardized to the DCCT standards.
Your daughter appears to be in a phase during which she makes enough insulin to get the fasting blood glucose down, but cannot handle food and the increased need for insulin. I would start insulin were I treating her.
LD
