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Question:

From Omaha, Nebraska, USA:

Our 10 year old has diabetes, and recently our six year old daughter has had continuous urinary tract infections and bed wetting episodes so we having been monitoring her We have had five high readings in the last month ranging from 185 to 283 mg/dl [10.3 to 15.7 mmol/L]. These readings are with a drastically reduced carb intake. She has cut back to about two carbs a meal (yes, we are trying to combat this) as she gets "stomach aches" when she eats a full meal. It was one of these episodes that I got the 283 mg/dl [15.7 mmol/L] reading.

My daughter's A1c is within normal range so the endocrinologist has currently opted not to test for antibodies. My wife and I are 100% convinced this child is in early stages of type 1. The endocrinologist is not our regular one and will not say yea or nay on the matter. I was under the impression that a person who does not have diabetes could not have a blood sugar of almost 300 mg/dl [16.7 mmol/L]. Is there any way this child could be having these levels? My gut tells me we have a child in very very early stages.

I am planning on seeking a second opinion. I would like to know that either I am paranoid and we should look elsewhere for the bed wetting, etc. Are we correct and need to begin what therapy we can to slow down the progression of islet cell destruction?

Answer:

The process of autoimmune destruction of the islet cells is a very slow one so it is quite common to get intermittent evidence of glucose intolerance before insulin dependence develops. Even though the blood sugars that you report may have been influenced by environmental stress and were not strictly fasting and the hemoglobin A1c was normal, in view of the family history, you should most certainly insist on an antibody test and a complete one for ICA512, anti insulin and anti-GAD, not just the immunofluorescent screening test for islet cell antibodies.

You might also call 1-800-425-836, which is the office of the national DPT-1 trial to see if they will still offer to do the test without charge. If it turns out to be positive, your younger daughter might still be able to enroll in the trial of oral insulin. Apart from that, the only published report that has claimed any effect in delaying insulin dependence has been one on New Zealand school children using the B vitamin, nicotinamide.

DOB

DTQ-20010501012519
Original posting 6 May 2001
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:22
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