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May 10, 2003

Diagnosis and Symptoms

Question from Pittsburgh, Pennsylvania, USA:

My six year old daughter has had several episodes of cyclic vomiting during which she needed hydration, and her sugar levels remained in the normal range. She was hospitalized four weeks ago on two separate days. The first day her sugar levels were normal, but on the the second it jumped to 342 mg/dl [19 mmol/L]. Since then, she completed a fasting glucose test that was 82 mg/dl [4.5 mmol/L], followed by a two hour OGTT. After the first hour, she had a sugar level of 107 mg/dl [5.9 mmol/L], and after the second hour, it went to 146 mg/dl [8.1 mmol/L]. Her pediatrician suspects type 1 diabetes. What are your thoughts? She takes periactin for the cyclic vomiting and was on Augmentin when she took the fasting sugar and the OGTT.

Answer:

None of the numbers on the glucose tolerance test are diabetes. See Classification and Diagnosis of Diabetes. Stress and the hospital is the most likely cause of the single elevated value. You could check glucoses at home or even urine for glucose. If positive then move forward to additional testing.

LD