From Valley Forge, Pennsylvania, USA:
Our pediatric endocrinologist suspects that our son may have transient hyperglycemia. What exactly is this, and is it a precursor to Type 1 diabetes? My son is totally asymptomatic but his blood glucose levels have ranged form 165 to 127 to 101 over a period of 1 week and his urine glucose has also been both high (+4 on the dipstick) and normal. If he does test positive for Type 1 diabetes, what is his prognosis for a long and normal life?
It is a little difficult to interpret the blood sugar data, because you don't tell me whether the values were taken fasting or at some time after food. An accurate and repeated blood sugar of 160 mg/dl fasting would certainly be abnormal and if there is confirmed evidence of significant glucosuria then the diagnosis really has to be Type 1 or autoimmune diabetes.
Transient diabetes is not really a specific diagnosis outside of infancy; but what happens in Type 1 Diabetes is that the erosion of pancreatic function occurs slowly over a number of years. In the months before permanent clinical diabetes develops, any stress, such as a mild infection, may result in a transient insulin insufficiency. Eventually the need for added insulin is permanent.
At this stage there are several ways to make the diagnosis. One is to talk to your doctor about doing a 'glucose tolerance test' with simultaneous insulin levels. Probably though it is more satisfactory to get an antibody test, which will almost always be clearly positive in cases of Type 1 Diabetes. There is a number to call if you or your doctor need more information on this, it is 1-800-425-8351.
Life Tables are not available for young people who have just been diagnosed. There have been so many recent advances in understanding the need for and how to achieve good blood sugar control however that if the diagnosis is confirmed you should certainly plan for a normal, if somewhat disciplined, life for your son.
Original posting 30 Aug 97
Last Updated: Tuesday April 06, 2010 15:08:54
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