From Long Island, New York, USA:
Since January of this year, I have been monitoring my now three-year-old daughter's blood sugars, as per her endocrinologist. Back in January, she exhibited occasional high blood sugars, but had no sugar in her urine. Her endocrinologist requested that I continue to monitor her blood sugar fasting and postprandially once or twice a day. The endocrinologist feels that my daughter does not warrant a diagnosis of diabetes at this time, but wants me to continue monitoring her because of occasional highs. We did have a period of about four weeks of very good/in range numbers both fasting and postprandially. Recently, my daughter's blood sugars have again begun to rise both fasting and postprandially, however, it is rare that I do get a number over 200 mg/dl [11.1 mmol/L] (highest recently being 214 mg/dl [11.9 mmol/L], retest 212 mg/dl [11.8 mmol/L], along with thirst and urination every 20 minutes.) Although testing has become routine for her at this point, I feel it's most likely not necessary to continue testing unless her symptoms become consistent. The doctor advises against stopping testing. She feels that any time a number is over 200 mg/dl [11.1 mmol/L], there is something wrong somewhere and that, at any time, my daughter's pancreas could fail. Is it truly possible that she would be in such a slow, long onset of diabetes? Typical numbers for her are anywhere from 85 mg/dl to 98 mg/dl [4.7 to 5.4 mmol/L] fasting. One hour after breakfast, a typical number would be 180 mg/dl [10.0 mmol/L] maybe a bit higher but, an hour later, she always goes down below 120 mg/dl [6.7 mmol/L]. She was negative for antibodies in January. What is your opinion?
Sorry to say that I agree with your physician. These are all abnormal values you are reporting even if they are not so consistent. So, the best diagnosis at the moment is glucose intolerance or pre-diabetes. I would be interested in knowing about islet cell antibodies, IA2 antibodies, GAD-65 antibodies and ZnT8 antibodies since these are the predictors of future type 1 diabetes. At this age, it is unlikely a slow onset LADA form and also unlikely a MODY form but we are just in our infancy learning about such variant types of kids' diabetes. The more you monitor blood sugar levels, the less surprised you will be if things change. Growth spurts and illness are the two most likely events that would be "triggering factors." I would advise that you discuss all of this with your physician so that all can agree how to proceed, what monitoring is needed, how often, etc.
Last Updated: Tuesday April 06, 2010 15:10:18
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