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Question:

From Pittsburgh, Pennsylvania, USA:

My 29-month-old daughter was visiting my mother-in-law recently. My mother-in-law, sister-in-law, and brother-in-law are all type 1 diabetics. My mother-in-law decided to test my daughter's blood about one-half hour after she drank some juice on an empty stomach; she was 287 mg/dl [15.9 mmol/L]. A half hour later, she was 155 mg/dl [8.5 mmol/L]. We took her to a doctor, who ordered blood drawn and a blood sugar level test done, which registered at 89 mg/dl [4.9 mmol/L]. They also did a urine test and the results came back normal. Over the next couple of days, we monitored my daughter's morning fasting numbers (all in the 80s mg/dl [4.4 to 4.9 mmol/L]), as well as her levels two hours after meals (all in the 80s mg/dl [4.4 to 4.9 mmol/L]). However, my mother-in-law tested her within an hour after meals a couple of times and she registered 206 mg/dl [11.4 mmol/L] and 269 mg/dl [14.9 mmol/L] on those tests. Are high readings like this normal within an hour after a meal or is this a sign of diabetes/pre-diabetes? She has no other symptoms (no excessive thirst or urination, no fatigue, etc.).

Answer:

At present, you cannot diagnose diabetes unless you have readings of 126 mg/dl [7.0 mmol/L] on two occasions fasting or 200 mg/dl [11.1 mmol/L] with clear symptoms. But, given the history, I would find an endocrinologist and ask for antibodies testing; they might be positive and helpful. Also, you can check her diaper for sugar in the urine and not have to stick her. With a glucose tolerance test, the glucose should not go over 200 mg/dl [11.1 mmol/L] at any time to be considered completely normal. It is the two hour value that counts to diagnose diabetes.

The main issue is to be aware and be watchful for symptoms. Diabetes in toddlers is often missed until they are very sick. It is true that every parent of a child should know the signs of diabetes, but given your family history, you should be especially watchful.

LD

DTQ-20081129203839
Original posting 3 Dec 2008
Posted to Diagnosis and Symptoms and Hyperglycemia and DKA

  
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Last Updated: Tuesday April 06, 2010 15:10:18
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