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What do you think?

Discussion in 'Parents of Children with Type 1' started by curious, Jun 4, 2006.

  1. curious

    curious Approved members

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    I use a glucomenter to check myself for lows - I am pregnant and tend to feel sick to my stomach if I am low, so if I eat when I am getting low, I can keep it at bay.

    The other day I was checking myself and my 6 y/o ds came up and said he wasn't feeling well and asked me to check him. I did and he was 187. It was about 2 hours after a relatively normal lunch (chicken fajitas, chips and salsa, and about 2 tbsp. of ice cream each) and my level was 115. I thought that was a little on the high side, so I took the meter to compare to our friends dd's meter (she has Type 1) and they were within a few points. My friend suggested doing a fasting level the next morning.

    The next morning, 12 hours after dinner of chicken, potatoes, and veggies, it was 169 (mine was 85 on the same meter). I had made sure his fingers were clean first, too. At this point I was worried, so I called the pediatrician. The only symptoms we had observed were our son complaining of stomach pain intermittently for the last month or so (usually center or left-sided) and him acting very out of character for the past few weeks. He says he's been really thirsty and hungry (I asked him in a multiple choice kind-of way) describing it as, "I wish I could eat 200 brick buildings and drink 200 slurpees!" I have not noticed an excess, but we have always allowed our children to eat as much as little as they choose, as long as they are reasonable choices. They also have free reign to all the water they would like and don't have to ask permission, so I really can't tell if he was drinking more than normal or not. He has lost a few pounds over the last few months, and also grown a few inches, so he looks quite thin. He's 48 pounds and 48 inches.

    Back to the pediatrician. They had me bring him in. I didn't allow him to eat before going in case they wanted any blood work that was fasting. The office was very busy and it was two hours later before they checked his blood sugar in the office with their glucometer. It was 80. The doctor decided to draw an A1C, which we will get the results of Monday, and told us to keep an eye on him for any more frequent or obvious symptoms. I will say that I am a very proactive parent and am quick to take my children in if I am concerned since we do have some health issues in my other children. The Dr. did say that knowing the type of parent I am, perhaps I was just quick to catch the early stages, or perhaps it was nothing. I am bringing him back in 10 days for a follow up from an ear infection he had a couple of weeks ago and she said they could re-evaluate him them if I was still concerned.

    Later that day, maybe 90 minutes - 2 hours after lunch of a subway sandwich loaded with tons of veggies, some Doritos, and a small amount of orange soda (a very rare treat!), I decided to check him again, just to see. My level was 107 (I had water and not orange soda). His was 249.

    I talked to my friend and she suggested that I just poke him fasting and maybe once a day for a few days and see what it comes up with. His fasting this morning was 94 and a random about 2 hours after lunch was 128.

    Now, I know home meters are not the way to diagnose diabetes, but if you were me, would you be concerned? Should I follow this? Does he need any different tests than what was done? Should I hand over the glucometer and leave the poor boy alone? I asked this on the ask the diabetes team section, but there is no answer there yet. I also didn't give as much information as I just gave all of you.
     
  2. muddymessalonskee

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    I would be concerned about these numbers, and continue to test occasionally even if the doctor determines that your son doesn't have diabetes now. My daughter was diagnosed with Type 1 in 2001; and at first we tested other family members now and then. We found slightly elevated values in my son several years ago; he was diagnosed with Type 1 this January. His A1c was 9.4 at that point, and we're now convinced that his insulin production was compromised at least as early as last June.) The problem is that by the time typical symptoms occur, the child may already be very sick, and the destruction of beta cells may have been going on for a long time.

    The following url has some information about normal blood glucose ranges.

    http://www.diabetes-eg.com/basics.htm#acceptable

    Deborah
     
  3. crystal

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    Your story sounds similar to what we are going through in our household with my 3 year old son. I am a gestational diabetic (on insulin shots 4 times a day in my third preganncy) and my curious 3 year old wanted his blood sugar checked one day last month after wathcing me check mine. I honeslty thought it was innocent enough. After a value of 182 an hour after eating (and a recheck of 183 on the other hand after careful scrubbing) and a fasting of 150 the next day we brought him into the pediatrician. My son's HgA1C is 5.5% and his random lab sugar was normal. We were told to use glucose/ketone testing strips and call if/when the results were positive.

    Over the past month I have randomly monitored his blood sugar and his fastings have been 95-155. 2 hour post meals are usually 126-180 with a few readings around 220-230. So far he isn't spilling glucose in his urine at all (even when his blood sugar reads over 200). At the beginning of the month I tested him at least once a day, now I realize that even though he likes having his finger poked and peeing in a cup I was making myself crazy. I am testing now only once a week or when I notice him drinking/peeing more often or being more cranky than normal.

    I figure if he is in the early stages of Type 1 is could take awhile to develop. I am also a nurse and know the signs and symptoms of hyperglycemia and DKA. I really hope that he doesn't develop Type 1 and that these random elevated blood sugars are just a fluke.

    I hope you get some answers for your child. I think the waiting and watching is hard. I really wish I had never poked his finger that first day. I never thought in a million years would something so innocent as his curiosity would leave me so worried.
     
  4. zookpr

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    I understand your concern, and would continue to watch him. My youngest son was very thirsty, peeing alot, hungry and cranky. Since my daughter is type 1, we knew these symptoms all too well. We started testing him and his numbers were what they classified as pre-diabetic. Because we caught them early, we were able to keep a watch on him and avoid the extreme DKA and the hospitalizations that my daughter went through. His diagnosis and ease into diabetes care has been much easier. Keep watching his numbers, if they start creeping up, insist on a repeat of tests at your peds!
     
  5. curious

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    Thank you for sharing your story. Please, keep me posted on your son.
     
  6. selketine

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    I would definitely keep an eye on things.

    My son got diabetes when he was 26 months old and in hindsight I could see his first major symptom was eating too much - and perhaps some behavioural issues too. But he was eating more and more and more and not gaining weight. Then he finally started the drinking and peeing. When he was dx'd his blood sugar was 430 but he was otherwise fine - no ketones yet and no dehydration, etc. He would have probably lost weight if not for all of the eating. The real strong peeing/drinking signs did not happen until after he caught a virus and had been on antibiotics. I would keep an especially close watch on him after any virus/illness. It seems that is the final straw for many kids.

    I would continue to feed him like normal and testing. I like idea of using the ketone strips on occassion. Ithink if you test every week or so (as the other person mentioned) that you would catch if his numbers start creeping up. Or certainly test if more symptoms come up - or take him back to the dr.!

    Is there not some test that can be done to catch pre-diabetes? I have seen some medical studies that try to catch kids as their diabetes starts to preserve the islet cells (or something like that).
     
  7. zookpr

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    They can do some blood work and find out how much insulin the pancreas is putting out. When my son first presented his was .6 and they dont want it below .8, I think. They can start them on low dose therapy to help preserve the islet cells longer. It doesn't prevent diabetes, it just seems to ease them into it rather than have them get very ill.
     
  8. curious

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    Thank you for all of your input. It seems the general consensus is to test him periodically and more if symptoms increase? That seems reasonable.
     
  9. Ellen

    Ellen Senior Member

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    I suggest you consult with a pediatric endocrinologist...preferably one who is board certified.
     
  10. curious

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    Really? Just based on a few high readings at home? I was beginning to think I should have left well enough alone and never poked him and that I was making a big deal out of nothing.

    Can a non-diabetic person have 3 higher than normal blood sugars and it amount to nothing?

    His fasting number this morning was 90.
     
  11. Ellen

    Ellen Senior Member

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    You wrote: "2 hour post meals are usually 126-180 with a few readings around 220-230. So far he isn't spilling glucose in his urine at all (even when his blood sugar reads over 200). "

    220-230 is far out of range - far from normal.
    Everyone spills glucose through urine at a different threshold.
    You may have caught this very early but your child should be followed by an expert. Almost NO pediatricians are experts in diabetes in children.
    I personally would want a baseline A1C test run and have my child followed by a specialist.
     
  12. curious

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    Actually, that was Crystal.

    The information about my son's readings is in my first post - the first post of this thread. My son had a fasting of 169, and two readings after meals of 187 and 249. His fasting levels the last two days were 94 and 90.
     
  13. curious

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    The pediatrician's office still doesn't have the A1C in. I was hoping that if that number came back low, I could put my fears completely to rest. :cool:
     
  14. Ellen

    Ellen Senior Member

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    Sorry about missing it was Crystal.

    If mychild's fingers were definitely clean and had the highs above, I would want to consult with a pediatric endocrinologist. But it's your decision.
     
  15. curious

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    Ellen~Thanks for your input. He sees the doctor again in 9 days and they said they will check into things again then.

    His a1c - they gave me two levels. One was 6.0 (she said that's in the middle of normal) and the other was 5.2 and I didn't catch the range on that one. So that all seems good, right?
     
  16. zookpr

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    Not to stick my nose in the middle of your conversation but :eek: , our endo said 5.5 was too high for a non-diabetic. My son had an A1c of 5.6, when they diagnosed him with type 1. They can't diagnose diabetes based on an A1c test.
     
  17. Twyla

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    don't completely rely on the A1c


    It's great that his current A1c looks good but that cannot completely rule out a diagnosis of diabetes, especially if you're catching it early. The A1c covers about 3 months so if he's just starting to have high blood sugars an A1c might very well not show it. Keep your fingers crossed but keep your eyes open!

    good luck,

    Twyla
     
  18. maverickmom (Kerri)

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    I don't know why that would be too high. Normal is 4-6% at most labs (varies by lab but most are around that) so as long as it is not out of that range it should be fine.
    Mine was 5.7% at an expo one year and everyone, including my daughter's endo, thought it was fine. I check my bgs periodically and they are usually fine.
     

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