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October 27, 2004

Diagnosis and Symptoms, Hyperglycemia and DKA

Question from Manasquan, New Jersey, USA:

In the past month, my four year old son has had sugar levels ranging sporadically from 84 to 461 mg/dl [4.7 to 25.6 mmol/L]. He was admitted to the local hospital then sent home with instructions to test his blood sugar three to five times per day. His levels have varied anywhere from the 90s to 250s mg/dl [5.0 to 14.2 mmol/L]. He was not diagnosed with diabetes. What other areas of diagnoses make sugar levels vary in that range? He definitely has good days and bad days..We have a follow up visit with the doctor next month.

Answer:

Unfortunately, it sounds like pancreatic insulin function is not normal. It could be an early form of diabetes, so that doing frequent blood glucose levels and knowing if they stay continuously high would warn you to contact the physicians. Sometimes there is just a temporary insulin deficiency that self-corrects. The more abnormal value and the higher the values, the less likely it is to be transient. Some antibody tests for islet cell and GAD65 antibodies would also potentially help to determine if there is inflammation already present or not. Negative tests won’t be absolutes, but positive tests (and how positive the results) are better predictors. The key would be to keep monitoring and stay in contact with your diabetes team so that they know what is going on.

SB