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December 1, 2000

Diagnosis and Symptoms

Question from Ilion, New York, USA:

Two years ago, my two year old son was suspected of diabetes due to some high numbers taken at home. He was having readings of 250+ mg/dl [13.9 mmol/L] one hour after eating. When we saw the specialist, he had a normal A1c, but they found sugar in his urine. They diagnosed him with diabetes and said it was probably very early in the disease, which would show the normal numbers most of the time. He was on insulin for a couple of months, and they eventually took him off the insulin, because he never had any more high numbers. He went back for a check-up six months later, and is doing fine. They have said they are unable to explain what had happened, except that it may just be way too early to diagnose. He has a paternal grandfather with type�1 diabetes, and I developed gestational diabetes. I have since been diagnosed with type�2 diabetes. My concern is that we have noticed a few symptoms as of late. Twice in the last month, he has had something that looked like rug burn in his armpits. We could not figure out what could have caused this. I sometimes get this same thing under my breasts, which my endocrinologist said is common in people with diabetes. He is thirsty quite often, also. I have been checking his blood lately. His fasting blood sugar this morning was 106 mg/dl [5.9 mmol/L]. Before bed last night, and two hours after his meal, he was at 158 mg/dl [8.8 mmol/L]. Are these acceptable, or in range numbers? Should I contact the pediatric endocrinologist again?

Answer:

A normal blood sugar range is typically right around 65-110 mg/dl [3.6-6.1 mmol/L]. This can minimally vary depending on the tester and the type of test you are doing, but is generally considered a normal range by most folks. When a child is having blood sugars that are dramatically above this, especially if they have sugar (glucose) in their urine, diabetes becomes a real possibility. It is important to closely monitor a child for sugar in the urine if there is any question about this being very early in the diagnosis. The “rug burn” you describe is probably acanthosis nigricans, which is a common finding in type�2 diabetes and occurs mainly in skin creases like the armpit or under a breast. I would recommend reviewing your concerns with your physician.

MSB