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Question:

From Long Beach, California, USA:

In the last two weeks, my two and a half-year-old grandson was over my house. I noticed some behavior change after his midday meal. He seemed spacy and almost drug-like. I thought it strange so I decided to check his blood sugar levels (as I myself am a food controlled diabetic, although I have problems with hypoglycemia regularly). I turned my pin down to 2 and gave him a quick check (he didn't even flinch). To my surprise, his blood sugar was 245 mg/dl [13.6 mmol/L]! I faithfully told my son when he came for the child. I didn't expect his response. He was angry and asked my to never check the child again. Whoa, I thought.

Well, a week later, when I watched the child again, I noticed the same thing after a meal and made the decision that the child needed to be checked. His level was 285 mg/dl [15.8 mmol/L]. I told my son again, who became defensive.

The next day, the child went to the doctor. The doctor told my daughter-in-law that I overstepped my boundaries. She said that I am not to be concerned over any of the child's health issues. They informed me the child could have been traumatized by worrying about his health prematurely (as per the doctor). They arrogantly told me this via a telephone conversation and "put me in my place." I was pretty amazed over this response. The doctor told them they would check the child in a couple of months at his three year check up (not to worry, she doubts this was nothing but a fluke).

Because of my concerns, they have unfairly charged me with traumatizing the child, are angry with me and won't speak to me directly. I am totally surprised. However, I must push my own pride aside, leave my arguments for politics and find some sort of clarity as to why the blood sugar readings were elevated for my little grandson. The doctor stated the child did not have any classic symptoms, but did order a urine test. Shouldn't there be more concern? Shouldn't an A1c be ordered? Could the child be diabetic without all the classic symptoms? I mean, I see some mood changes now and then with the child (he gets a little grouchy, but child do sometimes get grouchy when they are sleepy). I see the thirst (but it comes in wanting more milk throughout the day, not water). When he was an infant, he had numerous yeast infections, although that could of been from wet diapers. My own two children never had yeast infections or mood swings. I am concerned they will not pursue this. Is there anything I can do? Is there anywhere I can have him tested? Am I being unrealistic with my concerns? In truth, I have never traumatized this child and I am offended at the charge. What a ridiculous doctor!

Answer:

A blood sugar of 245 mg/dl [13.6 mmol/L] is clearly an abnormal blood sugar. We always hesitate to diagnose a child with diabetes based on the results of a handheld glucose meter because there are many factors that can confound the results of a home meter The child should be monitored for symptoms of diabetes such as excessive thirst, hunger and drinking -- as well as weight loss. A hemoglobin A1c is not used to screen children for diabetes. A urine test is not an appropriate first line test for diabetes either. Given the high blood sugars that you've seen, he should be followed closely by his pediatrician for the next several months, at least.

MSB

DTQ-20081019121246
Original posting 4 Nov 2008
Posted to Diagnosis and Symptoms and Hyperglycemia and DKA

  
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Last Updated: Tuesday April 06, 2010 15:10:16
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