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Question:

From Wisconsin, USA:

My 5 year old son was just diagnosed with Type 1 diabetes. His initial blood sugar was 253 and he was spilling ketones in his urine. But after arriving at the hospital (4 hours after the lab tests) his blood sugars were in the normal range and ketones were no longer showing in his urine. All the while we were at the hospital his blood sugars were normal. The doctors sent us home telling us that he is in the honeymoon stage. But since we have been home his blood sugars haven't once been above the normal range. (He is not on insulin yet.)

Is there any way of telling that he doesn't have diabetes? His blood test in the hospital to check his average range of blood sugar for the past 3 months was in the normal range. Is there any other condition that could of made his blood sugar high that one time? He had the flu 2 weeks prior and was not eating since and the day that he went in for the blood test he had 2 popsicles. I guess is there any test to confirm whether or not he has diabetes for sure?

Answer:

It is quite uncommon I admit for a 5 year old child to show high blood sugar with ketonuria just for a short while (4 hours). Anyhow, there are several possible explanations for what's happening in your son's case. Without knowing a little bit more about the family history and how exactly the diagnosis of Type 1 diabetes was made, the most certain way to confirm the initial diagnosis of Type 1 diabetes, or Type 1A as it is now sometimes called the autoimmune form, is to have an antibody test done and if your son is found antibody positive then he should be committed to insulin injection even in very small doses to prolong his honeymoon phase.

If he turn out to be antibody negative, here are some possibilities to discuss with your doctor. An occasional stress may sometimes cause a premature transient or mild clinical diabetes which progress eventually later on to the typical insulin dependent state. Another possibility (especially if he is of African American or Hispanic descent) is that he has what is now called Type 1B diabetes. In these cases the onset of the disease is essentially the same as in the autoimmune form but in many cases the need for continued insulin lasts only a short time. Moreover, there are a number of much rarer forms of diabetes such as MODY and the various forms of mitochondrial diabetes. A correct differential diagnosis between the autoimmune form and other forms of diabetes will assure your son a more rationale therapy (early use of insulin versus diet with or without oral agents) and a better future.

MS

Original posting 5 Apr 1998
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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