From Middlegrove, New York, USA:
My 6 year old son has had erratic blood sugars for at least the past year. His levels have gone from 27 up to 400 with repeated hospital admissions to stabilize him. On a daily basis his sugar levels will rise from normal up to 300, and then he can turn around and drop to the 50s or 60s. They have done the blood test that would say if he is diabetic and that came back normal so far. His pancreas is slightly enlarged and they don't why. Is this daily rise and fall in sugar levels harmful to him? His endocrinologist has no idea what is wrong with him. Would you keep searching for an answer or let time take its course? He has had a slew of unexplained ailments ever since he had Kawasaki disease at 18 months.
The story you give is rather a puzzle and especially so without more information. In particular it would be helpful to know what exactly "the blood test that would tell if he was diabetic" was. Also it wasn't clear whether he was on insulin; we presume not and finally whether your home blood glucose monitor has been checked and found to be accurate.
Some of the possibilities to discuss with his endocrinologist would be:
- Was the blood test a glucose tolerance test or a test for antibodies? If the antibodies were done and were negative then he might be one of the forms of diabetes like MODY (Maturity Onset of Diabetes in the Young) that can occur in his age group and that usually dont need insulin. This would explain the high blood sugars.
- The relatively sudden change to lower blood sugars is harder to explain. This might be an error in your glucometer though I would have expected this to be picked up during an admission, very occasionally in the early stages of diabetes, albeit much more commonly in the young adult, the gradual loss of islet cell function is signalled by a delayed insulin response to a glucose load rather than an absent one. This leads to high blood sugars after a meal followed by unexpectedly low ones two or three hours later.
- Was he by any chance given cortisone for the arteritis of his Kawasaki Syndrome? But that seems too long ago to be relevant.
- Is there any evidence that the high blood sugars are associated with any evidence of agitation? It is not impossible that the stress of many hospitalisations might cause high blood sugars; but again that does'nt expain the contrasting low ones. Just the same it might be a help to have you both meet with a medical social worker who is experienced with this age group.
This hasn't pointed to any obvious explanation; but if you think it would help you might consider forwarding the addditional information you have and we could ask the team to try again.
As to doing any harm I think it would be a help to have an A1c test done as this would tell you if the average bood sugars were above normal or were just evanescent. A high level would add some urgency to getting to the bottom of all of this which of course needs to be done anyway because of the repeated hospitalisations.
Original posting 22 Nov 97
Last Updated: Tuesday April 06, 2010 15:08:53
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