Info for possible t1 onset in a child

[nexus]

Hello all,

I'm an adult T1. I have a friend who had GD and her daughter just turned 1yrs old last week. A few weeks ago, she'd mentioned that her daughter kept getting a diaper rash even though she was being kept dry.. no ointments were helping at all. Well, I told her to switch the baby to soymilk and see if it helps.. which it did -- no more rashes.

Well, the other day she'd mentioned to me that the daughter was acting like she was always starving and constantly wanting to eat. Now with the rash issue and always starving sent up a red flag for me -- told her to test her daughter, figured since she had GD and the baby had lower then normal glucose when born, that maybe she was having hypos.. well she messaged me later on and said that she'd gotten her big toe and it was 139 -- tested again, after I had her clean the foot well, 141.

For dinner tonight she had 1 piece of baked chicken, few spoons of green beans and 1 slice of whole wheat bread.. she tested her at 1hr after eating on the forearm and it was at 130.

I asked her about if she's peeing a lot, she said that she changes her 4-6x a day, its usually pretty full, but not leaking out. She drinks a couple 8oz glasses of water a day along with soymilk throughout the day. She says she's not "tired" after eating, but by dinner she's really crabby -- because she won't lay down to nap in the afternoon.

I'm looking for insight here from other parents with T1 children.. for me I was sick in nov/99 and was in the hospital in DKA mid may/00 -- and had zero clue what was going on.. but I just have a real uneasy feeling about this, I'm sorry to say, and want to help my friend make sure to keep her daughter out of DKA *IF* what's going on is this..

TIA for any help.. I'm really stressed out for her and the child.

[munchkingirl]

Hi. Wow. Yeah, I understand about being concerned of symptoms you see in someone else. Honestly, though, most everyone i know - or have heard about - does end up in dka before they find out. In my opinion - her best bet is to take the baby to the doctor and have them test for diabetes - Saying she had GD and that she's seeing some symptoms and would like them to test - this can "catch it early" so to speak, hopefully preventing dka and the like - if it is diabetes. If not - maybe it's something else and it was a good thing for her to be brought in so it could be caught. OR, maybe it's nothing at all - and everyone's mind is put at ease. But in anycase - taking her to the doctor is probably the best thing to do - especially with those raised blood sugar readings. Since it's a little baby, maybe she's still producing enough insulin to keep the readings "under radar" or something.

Anyways, Hope this helps a little. Have a good weekend!!

Beth

[wendyc]

I know that many of our friends went on alert once our daughter (4yrs) was diagnosed last year. My sister-in-law is a nurse, and was constantly dipping her kids urine, and other friends were going to the docs. if they thought they were drinking too much. I would suggest to your friend that if she has any hesitation, go to the doctors. If there is something wrong, the docs. can catch it, and if it's nothing, her mind is put at ease. I hesitated, and only spoke with a nurse, who totally poo-poo'd my concerns. A week and a half later, we were in the pediatric ward with a 4yr old with BS readings of 740. When in doubt, go! Good luck to your friend.

[vix]

Hi, I understand your concern but personally as a T1 and mother myself think it's probably unlikely for a couple of reasons...

Gestational Diabetes is generally related to T2 not T1. T2 is exceedingly rare in a child of this age so even if there is a problem it probably could only really be T1 caught v.early. The fact the mother had GD is totally irrelevant to the baby - her blood sugars now would not be being affected now - the only impact possible would have been in the few hours after birth.

So could the child be developing T1? The age alone makes this unlikely, although not impossible.....

The numbers you are quoting do not seem to me to be that indicative of a drastic problem given that they were taken soon after eating and also given the margin of error that can occur in home testing machines. Diagnosis can only be made by accurate controlled tests for a reason!

The other "symptoms" you describe (nappy rash,hunger,crabbiness etc) could probably also be attributed to pretty much every 1 year old!

It really doesn't sound to me as if there is too much to worry about and certainally no need to panic.

You are obviously a caring friend and if the mother is concerned of course it's best to recommend she gets this checked out by a doctor, if only to put minds at rest.

Good luck
Vicky

[nexus]

Thank you all,

To vix: Actually, the mother having GD does have a bearing on the outcome of a child now. There is new supporting research -- also there have been mothers that have GD and turns into full blow T1 after birth -- same as if a child has low glucose when born they often have problems later on from what research is showing now.

To update, I spoke with her this morning.. the baby's fasting was 64 and for breakfast she gave her 3/4c of honey nut cheerios, 1/4 soymilk and few banana chips and at 1hr she was at 257.

She knew there was a problem and called, told the nurse and they got her in immedately, when she messaged me, she had to be there in 20mins. I'll let you all know more as I find out.

Thankfully, I know the signs -- perhaps this is one child that wont have to suffer dka.

[cydnimom]

I'm glad she took the baby to the doc. It so much better to be safe than sorry.

You mentioned that she was taking the bgs after 1 hr. Most postprandial readings are taken after 2 hours and normal range for a non-D person 2 hours after eating is 145 and under (I believe) so her numbers alone were not alarming, but putting everything together sometimes makes a clearer picture.

Hopefully it was nothing and maybe just a growth spurt because we know those hormones can cause insulin resistance. Please let us know how things turn out and you're friend is very fortunate to have you as a friend. Take care.

[nexus]

Hi,

Just got an update.

The doctor agreed that there is something wrong. They did a 2hr pp fingerstick in the office, came back at 104. The doc stated that a child
at 1yr should only be about 80-90 and has ordered several tests -- their
going to check with the insurance to see if they'll cover a GAD as well.

The doctor told her to keep checking her glucose, fasting, before meals
at 1hr after and 2hr after and to call him in 3 days with all the results.

I remember prior to my dx I had several hypos, which I had no clue what
they were at the time -- I later learned that it more then likely was the
progression of the disease.. So, who knows, we might be witnessing it
again with my friends daughter.. I think they need to do more studies on
the progression -- since by the time the symptoms arise, it's often too
late.

Thanks again everyone, I'll keep you updated.

[munchkingirl]

That is so good to hear that she took her baby to the doc. a 257 even for a non-d 1 hour after a meal is still rather high.

I think that being type 1 can indeed make us rather paranoid to others develping it - however - it's not a bad thing when it can be "caught early" and keep someone out of dka- cause that always sucks.

Keep us posted on how you all are doing! Have a wonderful day!

[BrendaK]

[QUOTE=nexus]Actually, the mother having GD does have a bearing on the outcome of a child now. There is new supporting research -- also there have been mothers that have GD and turns into full blow T1 after birth -- same as if a child has low glucose when born they often have problems later on from what research is showing now.
QUOTE]

I'm curious to what research on this has been done. I had gestational diabetes with my pregnancies, and with my first pregnancy, they put me on insulin over a month later than they should have. (They wanted to try a diet first.) Anyways, my oldest son was diagnosed at 9 months old and the doctors have been very emphatic that my gestational diabetes has nothing to do with him. I do have both type 1 and type 2 in my family, and I've recently found out that I carry very high antibioties for type 1 (but I do not have it myself). With my second child, I was put on insulin during my 20th week of pregnancy (with my first it wasn't until 32 weeks), and my sugars were much better controlled.

I'd love to see the research! Not that there's anything I can do about it now, but I've always just wondered if the severity of my gestataional diabetes had anything to do with Carson...

[nexus]

Hi BrendaK

I'll dig it back up, it's been a year since I read it. IIRC, it was in one of the diabetic journals from the ADA -- some research a doctor out of Loma Linda did.

I never was tested prior to becoming diabetic.. I developed mine after a bout with the flu, my daughter had the same flu as a matter of fact.. 6mon later I was in the ER in DKA.. and at the time, my daughter began to gain weight.. never putting 2 n 2 together until other symptoms she started to have, ie: stopped having her period, severe consitpation, moodyness, irritable etc.. our GP decided to run a full screening on her for various things, came back with 1600 antibodies for her thyroid and a TSH of 10.8 that in a week went up to 32.9.

Same flu, triggered two different autoimmune diseases in us.. Talk about guilt.. I definately gave her the genes. Though, only other person in our family that has a autoimmune disease was my grandmother with Alzhimers(sp) -- theres no thyroid problems, no diabetes.. though, lol me and my daughter were really the only ones that were thin out of entire family of obese people.. go figure.

[Mik's Mom]

Hi Nexus,

I'm glad your friend took her baby to the doctor. Just curious if your friend was able to do a ketone test on her baby? please keep us updated. :)

Best of luck to you and your friends!

[nexus]

Hi and thanks..

Yes, the doctor did a ketone blood test, was negative. Which I'd already told her it would be since she's not at the point of having constant high glucose or losing weight.

We'll just have to wait and see what happens -- I'll definately keep you all updated. She had another dr appt in 2weeks to bring in the childs food logs and glucose testing at home results.

[nexus]

I'm curious to what research on this has been done. I had gestational diabetes with my pregnancies, and with my first pregnancy, they put me on insulin over a month later than they should have. (They wanted to try a diet first.) Anyways, my oldest son was diagnosed at 9 months old and the doctors have been very emphatic that my gestational diabetes has nothing to do with him. I do have both type 1 and type 2 in my family, and I've recently found out that I carry very high antibioties for type 1 (but I do not have it myself). With my second child, I was put on insulin during my 20th week of pregnancy (with my first it wasn't until 32 weeks), and my sugars were much better controlled.

I'd love to see the research! Not that there's anything I can do about it now, but I've always just wondered if the severity of my gestataional diabetes had anything to do with Carson...

Here's what I was able to dig back up Brendak..

http://www.ahcpr.gov/clinic/epcsums/impglusum.pdf#search='studies%20of%20normal%20pedi atric%20glucose%20levels'

Offspring of mothers with pregestational or gestational DM
(ODM) also have a higher prevalence of IGT. In a
longitudinal study, the prevalence of IGT in ODM was 1.2
percent in children < 5 years (n = 168), 5.4 percent in 5- to 9-
year-olds (n = 111), and 19.3 percent (95 percent CI 12.1 to
28.6) in 10- to 16-year-olds (compared to 2.5 percent [95
percent CI 0.4 to 8.1] in controls).76

You can read more about it in that Journal, I was under Pediatric Studies. iirc Section 4.

---
child is still holding her own, fasting is starting to rise now to 80-90's as is post prandals, at 160's.. .Only time will tell.

[vix]

Hi Nexus,

I think I must be missing something here...isn't this article about Gestational Diabetes and the link with possible glucose intolerence for the child in the future (and likelihood of developing T2)?
I can't see where any link whatsoever between GD and a child developing T1 is mentioned....

I do hope all turns out to be ok with your friends baby.

Vix.

[Ellen]

I hope the 1 year old is being seen by a pediatric endocrinologist. A general pediatrician is not the one to evaluate this case.