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Question:

From Soldotna, Alaska, USA:

A naturopathic doctor suspects that my six year old son has type 1 diabetes, since he shows symptoms of abnormal thirst and frequent urination. He performed a "pancake test," where he checked my son's fasting blood sugar (eight hour fast), then sent him out to eat pancakes and syrup, then tested his blood sugar again at one and two hours. Fasting, it was 107 mg/dl [5.9 mmol/L], after one hour, it was 165 mg/dl [1.2 mmol/L] and after two hours, it was 228 [12.7 mmol/L]. He ordered my son on a no sugar or refined carbohydrate diet and referred us out to a general practitioner.

While waiting for the referral, we tested his urine at home for ketones, which showed none to a trace. Our pediatrician didn't feel that this "pancake test" was an accurate test, and the readings in his opinion were "not that bad." He then ordered a fasting blood test. He called us with the results, which were "perfectly normal."

Somehow, I still can't shake the idea that something is going on with my son's blood sugar. Since March, he has had episodes of a "heavy head," blurry vision, nausea and vomiting, which recurred immediately after the "pancake test." Also, he has often had bouts of uncontrolled crying for no reason and becomes extremely irritable and irrational when he hasn't eaten. He magically returns to normal after he eats something and sometimes seems not to even remember the erratic behavior.

There are cases of type 2 diabetes on all sides of our family, but none of type 1. My son is healthy, active and thin. Should I seek a second opinion? Or, should the test from our pediatrician be the end of it? Could these symptoms be something other than diabetes?

Answer:

If your son has symptoms of diabetes, abnormally frequent urination, excessive thirst, weight gain or loss, and excessive hunger, he clearly may have diabetes. Although a fasting blood sugar can be used as a screen for diabetes, a more accurate test may be a formal two hour glucose tolerance test which can pick up an abnormally high blood sugar in response to eating sugar (which may be similar to your naturopath's "pancake test"). If your son's blood sugar done on laboratory testing equipment (not a handheld glucometer) was 228 mg/dl [12.7 mmol/L], he clearly has a problem that should be evaluated by a board certified pediatrician that has experience in diagnosing and treating diabetes in children.

MSB

DTQ-20051118001359
Original posting 21 Nov 2005
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:10:04
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