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September 7, 2006

Diagnosis and Symptoms

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Question from Provo, Utah, USA:

My 15 month old daughter has not been feeling well for a while and she has not been gaining much weight. In the last several days, she has wanted to drink water all the time and has had many, many wet diapers. We checked her blood sugar and it was 191 mg/dl [10.6 mmol/L]. We took her to the doctor today because she has had a high fever and while we were there we mentioned this to my doctor. He said that it needed to be over 200 mg/dl [11.1 mmol/L] before we start to worry. He said we should take her blood sugar fasting, if we have access to a monitor, which we do because my brother has type 1 diabetes. I have a monitor also because I had gestational diabetes. I also have PCOS. Should we push for the doctor to do more testing since she wants to eat and drink all of the time and her weight has been staying the same or going down recently? Is 191 mg/dl [10.6 mmol/L] something to worry about?

Answer:

From: DTeam Staff

I think everyone is right on this one. True, a random glucose of “191 mg/dL” does not fulfill criteria for diabetes, but given the less than complete accuracy of home glucose monitors (they me be off by 10 to 20% compared to a laboratory, which typically may only have less than a 5% error rate), the 191 mg/dl [10.6 mmol/L] might really be higher.

I agree that a fasting glucose is in order, but I would take the baby to a laboratory to get it done, not rely on another fingerstick with the home meter.

Given the symptoms, your family history, and this high glucose reading, I think a more aggressive evaluation for diabetes is not at all unreasonable. MAYBE this only reflects an intercurrent illness or effects of some medications. However, I think you want to be aggressive in pursuit of this.

DS