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Question:

From Tennessee, USA:

My son is nine years old. A couple of years ago, he had some issues with high blood sugar levels. We took him for some testing and the doctor told us to take a wait and see approach and to monitor him when he seemed to be exhibiting symptoms and randomly. The numbers stabilized and he's seemed fine to me all this time.

On Monday, I took my son for a routine physical. He was 4 feet, 7 inches and weighed about 85 pounds. As a matter of record, since we hadn't seen this doctor before, I told him about the past high blood sugars, but that I hadn't noticed any symptoms. He gave me a glucometer and said to check it weekly.

On Wednesday morning, before he left for school, I checked my son's blood sugar and it was 212 mg/dl [11.8 mmol/L]. On Wednesday at 10, my older son went in for a physical. When I told the doctor about the reading, he said that my son was diabetic. He wrote me a prescription for test strips, swabs and lancets. He said that he would send my son to the nutritionist and educator at the hospital. If diet and exercise didn't help, he would put him on insulin. He didn't ask me to bring him in for testing or anything. He just said to test his blood a few times a day. Do I need to go ahead and alter his diet? When we were dealing with this before, they told me not to alter his diet because, at his size, it was probably type 1 and we needed to see how his levels reacted to food. Before when his levels were elevated, he definitely wasn't overweight. Now, I would consider him to be chunky, but not obese. I spoke to the educator yesterday and the nutritionist today and they can't see him for 11 days.

I know his levels aren't extremely high, but I'm still concerned. I'm checking him fasting and two hours after he eats. Last night, he was 134 mg/dl [7.4 mmol/L] post meal. This morning he was only 98 mg/dl [5.4 mmol/L] fasting. I'm not even sure what normal levels are. I seem to get a different answer everywhere I look. Could this have been a fluke or is the post meal number too high also? Before, his numbers would go up to the high 200s mg/dl [14.4 to 16.6 mmol/L], but they eventually stabilized and stayed down. Was that a honeymoon period? There's just so much information and it's hard to decide what's going on.

Answer:

Certainly you will not get into trouble while testing. Clearly, very high blood sugars warrant a doctor's call and visit.

The real question is what is going on. The random glucoses you are seeing may or may not be abnormal. That's the problem with self-monitoring and the random individual glucose. There are tests that can help. I would ask for a referral to a pediatric endocrinologist and let them move from here.

I suggest you review What is Type 1 Diabetes? on our site. It really looks like his A1c is going to be much more important in the future for diabetes management and even diagnosis.

Lastly, healthy eating is never bad. Do look at your family and be healthy. Eighty-five pounds, while not truly obese isn't skinny either. I recommend you encourage lots of activity and healthy eating.

LD

DTQ-20070830201812
Original posting 15 Sep 2007
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:10:12
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