May 15, 2006
Diagnosis and Symptoms
Question from Simi Valley, California, USA:
My 34 year old husband was diagnosed with type 1 diabetes when he was six. I know there isn’t much correlation, but we believe our three year old daughter has it also. She started complaining of urinating too much. We also noticed her urinating a lot this weekend so we checked her sugar. I am a nurse so I know how to check a sugar and know I am not doing it wrong. The very first sugar we took was 240 mg/dl [13.3 mmol/L]. We scheduled an appointment with the doctor, but went to have a glucose test done first. Yesterday, when I first got her up, her sugar registered at 311 mg/dl [17.3 mmol/L]. One and a half hours later, at the laboratory, it was 87 mg/dl [8.3 mmol/L]. Is this possible? Does it make a difference that they were unable to get a venous sample and had to poke her finger and get it by neonatal tubes? If she is barely diabetic, is it possible that her crying and throwing a fit will bring down her sugar? It seems like this has happened a few times. Last, but not least, we also dipped her urine and it only showed some trace leukocytes, no sugar. We are going to get some strips for a brand new machine that we happen to have and see if it makes a difference, even though the old machine (only six months old) has been providing my husband with accurate results.
Answer:
It certainly is not normal to have such high blood glucose values. The fact that they change so quickly, assuming that the tests are done accurately, occurs in very early diabetes when the pancreas is just starting to fail in its ability to produce insulin at the correct times. So, I would continue to monitor your child closely several times each day. You may also want to contact a good pediatric diabetologist to get antibody tests done: islet cell antibodies, GAD65 antibodies and insulin antibodies may be positive, but not always, in such young age children. If negative, it does not give you much comfort since they are negative about 30 to 40% of the time; if positive, then you know that the pancreas will eventually fail and she will need insulin. So, positive testes are diagnostic of inflammation involving the pancreas and high risk for developing diabetes. Overall, we think there is about a 2 to 5% chance of a parent with diabetes having a child with diabetes.
SB
