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New...need to know what "normal" is.

Discussion in 'Parents of Children with Type 1' started by TrishaP23, Jul 1, 2011.

  1. TrishaP23

    TrishaP23 Approved members

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    I hope this doesn't fall under the "I think my child has diabetes" thing stickied at the top of the board. I promise I'm not looking for a diagnosis here, just some more information so I know whether I need to push further with her doctor.

    I'm a type 1 (probably 1.5) diabetic and feel I'm quite knowledgeable on it...at least for myself. But I'm not sure if things are different for children.

    My 19 month old daughter seems to drink a lot. Being a diabetic myself I already test my kids once in a while and have always gotten good numbers. Well last night my daughter downed a cup of water in about five or ten minutes so I pulled out my meter.

    Initially I got 247, but I hadn't cleaned her hands. So I washed them really well and retested, multiple times. I got a range of 190-209 doing both her fingers and toes. This was probably about an hour after eating. I know in adults when doctors want 1 hour PP they usually want 140 or lower. And I know my husband can chug a bunch of Mountain Dew and if I test him immediately or half hour or an hour later he's always right around 100.

    The last reading I took was 201 (probably an hour and half after eating) and then I waited just over a half hour and then she was down to 126 and 123. I let her go then. Tested her once over night (90) and a fasting in the morning (75).

    Personally I think diagnosing diabetes on fasting alone is downright stupid. So, I'm glad her fasting is still good but I'm not particularly comforted by it.

    So, she ate breakfast and in a similar time frame was again hovering around 200.

    I called her doctor and took her in. They weren't really concerned about the numbers, said kids could run higher. Offered to do a fasting if I wanted but why have her go through a blood draw when I can poke her myself at home and a fasting doesn't necessarily mean anything in the grand scheme of things? So they put a urine bag on her and tested her urine. No glucose (her sugar was only 113 at the time as she hadn't yet eaten lunch...I didn't expect any sugar to be in the dip) but there was some blood and something else that I'm not sure about (something gravity I think) but the doctor said they'd have nothing to do with diabetes. Her urine was very concentrated, though, indicating some dehydration. But with as much as she drinks I can't imagine she should be dehydrated (and she drinks almost solely water, only one cup of milk a day).

    Everything I know as a diabetic tells me 200 is too high. If I'm at 200 I take a correction bolus to bring it down. Now I know, okay or not, these fairly short stints at higher numbers aren't really going to cause her any harm. My concern is that the short stints are going to become longer and her sugar is going to go higher.

    She did have a GAD test done in January as part of the TrialNet study and at that point she was negative for antibodies but I know this isn't a guarantee that she won't get diabetes and/or the antibodies didn't start forming since then.

    I've run into quite a few doctors that just don't seem to have much of a clue about diabetes. Even my endo diagnosed me with "autoimmune type 2." ??? So it's hard for me to trust a doctor that says, "Oh, it's fine. We're not going to do anything."

    With these numbers would you be pushing for further testing and/or looking for a different doctor or at 19 months are 200-ish numbers within a couple hours after eating really okay?
     
  2. TrishaP23

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    23 views and no replies. Can somebody please just tell me if I'm being paranoid or if I need to look into it further.

    BTW, she's running similar numbers after supper again tonight so far.
     
  3. Lisa P.

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    You are right that the board kind of frowns on anything but "check with your doctor" for these kinds of maybe questions.

    However, I think it's fair to say I'd certainly not consider 200 a normal number. I can even go so far as to find one 200 in a long while just a fluke, but if you get it consistently in the hours after eating carbs it seems very clear to me that something is going on. It doesn't have to be diabetes, but I seriously doubt it's healthy. If the doctors think it's something other than diabetes, it seems to me there should be some effort made to find out what it is.

    A good way to check for a kid with diapers is to put cotton balls in the diaper and test the urine you squeeze out of that. I'd check for both sugar and for ketones. I'd find the best ped endo in your area and call him or her. As you say, the degree of ignorance many (not all) pediatricians and other GPs, etc., have about diabetes is amazing. I also think most pediatricians have an inherent desire to not believe kids as young as yours can have diabetes. They are humans, and they just don't want it to be true, sometimes they are flat out in denial, I think! A ped endo will have no such obstacles.

    Of course, watch for the emergency signs, since I believe onset can escalate.

    For reference, though, I have tested one of my nondiabetic children in that range on occasion. She wound up having a blood pressure problem that affected her digestion and nervous system, it wasn't diabetes.

    This must be very hard for you. I hope all turns out well. I do believe infections can cause elevated numbers in nondiabetics. But I think you are wise not to close your eyes in case there's something that needs to be seen.
     
  4. Lisa P.

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    Folks will be reluctant to answer in order to respect the board, it's not about you. Folks also view but don't reply if they have no good answers for you. I think you know as much as anyone on this board knows about your situation. It seems clear to me you probably, I'm sorry, already have your answer. You need to keep asking and looking for answers, it seems. Wish I had a different answer for you. :cwds:
     
  5. TheFormerLantusFiend

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    Normal blood sugar is the same for children (except newborns) as it is for adults. Your daughter's blood sugar might be explained by whatever is causing the blood in her urine.

    I would be very concerned about blood in the urine of a toddler.
    Specific gravity of urine is how much it weighs compared to water. Normal is 1.005 to 1.030 times as heavy as water. The specific gravity can be high because the urine contains any of a number of things- including blood and sugar. Mine was high at diagnosis (I had lots of sugar and lots of ketones) but in your daughter's case, it's probably the blood.

    If I were you, I'd stick with this doctor while figuring out and treating whatever is causing the blood in the urine. I'd keep an eye on the blood sugar, but not try to get any diagnosis for that unless it got worse. If you do want to get a diagnosis, and she's not running high numbers before meals but is after meals, you should probably give something sugary prior to the appointment so the doctor can see her high.
     
  6. TrishaP23

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    Thank you. I do understand that my post is kind of in a gray area as far as the "does she have diabetes?" thing. I apologize if I came off short. I tend to be pretty anxious about health stuff (not a true hypochondriac but close enough) and that projects onto my kids too. So, I'm at odds with myself right now over whether I'm freaking out because it's just what I do or if I have some reason to and I was looking for other knowledgeable people to tell me what would be considered normal because everything I know about diabetes tells me this ISN'T normal but her doctor today wanted to brush it off. :(

    As far as illness, she doesn't have any symptoms of anything so I'm thinking no. I don't know what else might cause elevated BGs. And I don't think her doctor was insinuating that whatever was going on with her urine had anything to do with her blood sugar.
     
  7. TrishaP23

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    Thank you. Both me and my grandmother have/had blood in our urine all the time. I had urinary reflux as a child that corrected itself but I had a lot of bladder infections until it did. My daughter has never shown signs of a bladder infection. The blood is still in my urine even though the reflux issue isn't present anymore. I think they just consider it idiopathic and it doesn't seem to cause any problems or be caused by any. So she may just take after me on that front. We do have a follow up appointment next week to have her urine tested again and I guess if there are similar results then they'll do further testing.

    I definitely plan to "sugar" her up prior to any appointments about her blood sugar so they can see for themselves. Sometimes it feels like they think you're making things up or that you hallucinate things or something.
     
  8. Lisa P.

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    I didn't read your post as short, just as anxious. Just wanted you to know if you don't get replies it's not about you! Folks care, they just don't necessarily have a good answer. Me, now, I'll talk out my ear on any subject I have no clue about any time, I'm not shy. . .:p

    Having certain tendencies myself, I found it interesting that I read once that hypochondriacs tend to have in the long run shorter life spans, etc. (I think that was the stat). The reasoning was that their ability to discern risk is "broken", so they are not able to judge what is a real problem that needs addressing as easily as a non-hypochondriac.:D

    I think the problem in this area is that if you check diagnosis stories you'll see how very frequently doctors ignore signs of diabetes until DKA. So personally, I'm never comfortable when a mom says she thinks her kid has a health problem and the doctor tells her she's wrong, leaving it at that. If your doctors are not pursuing the question of why her bg is elevated, I'd insist or find other doctors. I've never heard of an instance where a child regularly has bg of 200+ and does not have a health issue, but I think even if that situation exists I'd want a doctor to give me enough specifics that I understood him or her, not just tell me not to worry about it.

    No matter what you do, I would definitely check ketones.
     
  9. C6H12O6

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    With undiagnosed diabetes or hyperglycemia the urine would be dilute not concentrated.
     
  10. mmgirls

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    Yes I would carb her up before the test.
     
  11. fredntan2

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    When I, wore the CGMS couple of years ago during our learning how to use it phase, my bs certainly went into 200 or very close to it after eating. I don't have diabetes. And had blood draws at my drs and my blood sugars a1c is all good.

    I personally don't think that since CGMSs have come out that they have done lots of testing on non D to see what really happens to our sugars
     
  12. Ellen

    Ellen Senior Member

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    I'd ask for a referral to a ped endo
     
  13. TrishaP23

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    Thanks everyone. I e-mailed a pediatric endo with what's going on and asked them if they felt I should push it further. Being the July 4th weekend I'm not expecting a reply until Tuesday at the earliest.

    I'm going to post a new thread with another question so I can compare what's going on with my daughter to some of your stories and see if I find similarities or not.
     
  14. Darryl

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    Here is a chart showing normal glucose trends in nondiabetics monitored on a CGM
    http://www.diabetes-symposium.org/index.php?menu=view&source=&sourceid=0&id=322&chart=20

    There is no difference to my knowledge between nondiabetic children and adults in terms of normal blood sugar.

    According to the OGTT test, anything up to 200 is normal for a very brief period of time after a high carb (75c) meal. Within 2 hours BG should be down to 140 at the very most. Fasting of around 80-90 is normal.
     
  15. Heather(CA)

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    I hope it's nothing, but I'm a big believer in trusting your gut...:cwds: I would be concerned with 200's. I have tested myself after some crazy meals but I have never been over 120.

    My best friend called me just over 3 years ago to tell me her daughter was in the 200's but her test strips were out dated. I told her to give her a HUGE glass of OJ and take her to the Doc. Unfortunately she was 500 when they got there...She was dx'd that night.:(
     
  16. SarahKelly

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    This is just my experience - I felt my son was thirsty more than normal and being more cranky than normal, I tested his BG and it was 229. Called his pedi and she said not to worry he probably had an infection and had elevated BG due to that. I washed his hands rechecked him and he was still 229, waited an hour and he was down. I tried to ignore my gut feeling and think his pedi was right, but I just knew...two months later he was obviously sick, I checked him again and the meter gave me that horrid "HI" greeting, off to the ER we went.
    BUT
    That is just my families experience. I have another girlfriend (her son has d), has a nephew that spiked whenever he has strep...so, for his family they just know it's his pattern and has been for almost a decade. I guess it can occur when infection is occurring.
    Again, I have no clue what is going on with your child medically, just our experience and the whole time I was in direct contact with our pedi and even met with a endo just in case (who sadly assured me Isaac was fine!)
    I hope all is fine with your daughter and you get answers soon from a medical professional.
     

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