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November 14, 2002

Diagnosis and Symptoms

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Question from Roanoke Rapids, North Carolina, USA:

At my 18 month old daughter’s checkup, the doctor did a blood sugar which was 175mg/dl [9.7 mmol/L]. He said this was a little high and told us to keep a eye on her. Since my grandmother had an extra testing kit, we borrowed that, have been checking her a few times a day, and she has ranged anywhere from 24-200 mg/dl [1.3-11.1 mmol/L]. Her doctor keeps telling us that as long as it doesn’t stay high or low, she is fine and that the normal range would be 60-180 mg/dl [3.3-10 mmol/L], but everything I have read says that the normal range is 80-120 mg/dl [4.4-6.7 mmol/L]. Which is right? Also, he doesn’t seem to be concerned at all.

I know the meter is calibrated, and her hands are clean each time we check her. Also, my mother (who used to take care of a child with diabetes so she knows what she’s doing) has checked her. My mom had her this morning, checked her. and she was 24 mg/dl [1.3 mmol/L]. She washed her hands again, checked herself to make sure the meter was okay (She was 98 mg/dl [5.4 mmol/L]), then checked my daughter again, and it said 23 mg/dl [1.3 mmol/L]. Should I be concerned? Her doctor seems to be blowing me off. Should we get a second opinion? Should I ask to be referred to a pediatric endocrinologist?

Answer:

I can’t for the life of me explain why an 18 month check up should include a blood glucose test. You don’t mention any symptoms of diabetes, and I think you should stop taking blood tests from your daughter. If she develops symptoms of diabetes, then by all means seek a second opinion. What you describe is the inevitable result of inappropriate over-investigation.

KJR