From Paintsville, Kentucky, USA:
My daughter, age seven, began complaining of headaches. Her glasses were changed, but the problem still existed. Then, she experienced extreme polyuria for about one week. After a week of this, I did a fasting blood sugar. My sister was diagnosed at age 13 so I was fearful. Her blood sugar was 384 mg/dl [21.3 mmol/L]. I took her to her pediatrician and he did a blood sugar, which was 584 mg/dl [32.4 mmol/L]. Diagnosis: type 1 diabetes. They admitted her and started her on insulin. She is now in "the honeymoon phase." Her A1c is 6.2%. She has several bouts with hypoglycemia now.
She was nine pounds at birth, from a healthy pregnancy. Neither her father nor I have diabetes, but my sister has type 1 and two uncles have type 2. My daughter was always a healthy child except for recurrent bronchitis and a bad case of chicken pox. She has always been bigger than kids her age. She is 4 foot, 5 inches and weighs 90 to 93 pounds, a little overweight, but very active. She was a very healthy eater both before and after diagnosis. I question whether it is type 1 or type 2 because she also fits category for type 2. She has no acanthosis nigricans. She was negative for islet cell antibodies, but positive for GAD antibodies. I have asked many times and the doctor is convinced it is type I. However, he does note that she is overweight and in fact, calls her obese.
Is he thinking type 1 because she is only 7? Or, are the positive GAD antibodies enough to confirm? All the literature I read makes me curious about it being type 2 because she didn't have weight loss at onset or before diagnosis; she is overweight. Is there a more definitive, more absolute method of determining the diabetes type? I hate to keep asking the doctor, but I need reassurance that we know for sure which type it is. I feel that type 2 gives me hope she can come off of insulin shots with proper diet and exercise and regulating her blood sugar.
I think you are asking a common question, but the wrong one. It does not really matter whether this is type 1 or type 2. By age, type 1 is more likely. If there are thyroid and celiac antibodies also present, it is more likely type 1 than type 2. The key question is how to get and keep the blood glucose levels as close to normal as possible without excessive or severe episodes of hypoglycemia. With positive antibodies, type 1 is more probable. Being overweight probably adds to the risks for earlier development of type 1 diabetes. This is a theory proposed by colleagues in the U.K. called the accelerator hypothesis. You should go back and discuss this with the diabetes team so that your questions are answered specifically for your child and with the best knowledge gained from her blood glucose readings and the laboratory results currently available. Time will help sort this out. In any case, getting her weight towards ideal is a key goal at the same time optimizing blood glucose control.
Original posting 30 Sep 2004
Posted to Diagnosis and Symptoms
Last Updated: Tuesday April 06, 2010 15:09:58
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