Pre-diabetes type 1 with their child? Or are a diabetic educator? (LONG)

[mamato3 all-boy boys]

We had a really chaotic, scarey week last week. My 5 yo had his well-child visit on Tuesday morning. He gave a urine sample, and the dr. found sugar and ketones in it. A few minutes later, a finger stick showed blood sugar at 256 or (I cannot remember now). The dr. sent us to the local hospital for a metabolic panel, which showed blood glucose at 239.

 

Now, here I need to back up and explain what had gone on in the previous 24 hours. On Monday (day before appointment), my son ate a regular breakfast, only 1/2 of his spaghetti and meatball lunch, and ate *no* dinner -- he was whiny about the meal I was serving, so I stuck to my guns and told him that I'm not a restaurant and he eats what I'm serving or nothing until breakfast. He chose nothing.:tongue_smilie:

 

Ds wakes up at 4 am to throw up. DH said it was mostly clear, but there was definitely emesis gagging going on in there. Son woke up at 8 and had 3 bowls of maple and brown sugar Life for breakfast (there's 8 g of sugar per serving, but I doubt each bowl was a full serving) as well as toast and butter. At 9 am, we're at the dr. and he gave his urine sample. The blood sugar test occurred at close to 10 am, and the metabolic panel at 10:22 am.

 

So, our pediatrician (a really great doctor) sends us to the nearest teaching hospital a few hours away. As he's telling us the details I relay to him the craziness of ds's eating habits in the previous day and ask him if that mess could've prompted the blood sugars. He said no.

 

At the hospital, they check his blood sugar in the afternoon, evening and the next morning. Each time, his blood sugar is getting closer to a normal range (and finally is normal) and they discharged us before lunch. There were no ketones in his urine except the first time upon admission.

 

At discharge the dr. and intern (and med student) all tell us they think ds does NOT have diabetes, but just a weird reaction to some stresses: his eating the previous day, a crazy fall sporting schedule with his other brothers leading to perhaps some over-tiredness, and getting over a cold the week before. But, the have us check is blood sugars before a meal, and then 2 hrs. after a meal per day for the next two weeks. And continue to check for ketones.

 

Our pediatrician called today to check and see how ds is doing. I tell him all pre-meal fingersticks have been normal (80s) except yesterday's and todays: 131 and 132. I made sure to test before lunch and it had been 3 hours or more since ds had last eaten. The after-lunch sticks were in the 90s.

 

My pediatrician seems to think that ds is pre-diabetic and his pancreas is in the process of failing. As I mentioned above, the hospital's ped. and their pediatric endocrinologist (whom we never saw personally, but s/he talked to the admitting pediatrician) seem to think it was a blip.

 

I just don't know what to think, and as I've gotten online to research more, I'm getting more confused. Certainly, I need to be patient and wait and see what will happen, but I thought I'd seek out some experienced people on my own.

 

Thanks for insights,

[Lawana]

Dd is Type 1 diabetic, so this is where I'm coming from.

 

First of all, were the 130's blood sugar readings before meals, or after? That is very important in determining their significance.

 

It may very well be that your ds's pancreas is in the process of failing. It may well also be that what you saw was a fluke. Only time will tell. Be thankful that the medical persons involved recognize that a failing pancreas may be a possibility. Too many will only diagnose on given criteria, and don't recognize a "pre" Type 1 state, as, traditionally, Type 1 is considered to have a sudden onset. Based on the experiences of some, however, there are cases where symptoms are present for a year or more before an official diagnosis is made. Since this flies in the face of mainstream medical wisdom, it definitely makes things harder.

 

I participate in an online forum for parents of children with diabetes. Your experience is not unheard of, and is, unfortunately, problematic because it falls into a grey area. Not "not" diabetic, but doesn't completely meet the diagnosis requirements to proceed as "my child has diabetes, this is what I must do."

 

If this is confusing, or if you wish to discuss it further, please pm me. I'd be happy to correspond.

 

ETA: Are there any other symptoms involved, such as wetting, increased thirst, increased urination, behavioral issues?

Edited November 2, 2010 by Lawana
adding

[mamato3 all-boy boys]

Lawana,

 

The 130s were before a meal. On both Sun. and today, I decided to check his pre-/post-lunch levels. Tomorrow I'm going to check his pre-/post-breakfast levels, to get more variety in the data. The pediatrician also wanted me to "stress" his diet and see how he did with a big fast-food lunch, etc.

 

I'll pm you. Thanks SO much for responding!

[vettechmomof2]

Dd is Type 1 diabetic, so this is where I'm coming from.

 

First of all, were the 130's blood sugar readings before meals, or after? That is very important in determining their significance.

 

It may very well be that your ds's pancreas is in the process of failing. It may well also be that what you saw was a fluke. Only time will tell. Be thankful that the medical persons involved recognize that a failing pancreas may be a possibility. Too many will only diagnose on given criteria, and don't recognize a "pre" Type 1 state, as, traditionally, Type 1 is considered to have a sudden onset. Based on the experiences of some, however, there are cases where symptoms are present for a year or more before an official diagnosis is made. Since this flies in the face of mainstream medical wisdom, it definitely makes things harder.

 

I participate in an online forum for parents of children with diabetes. Your experience is not unheard of, and is, unfortunately, problematic because it falls into a grey area. Not "not" diabetic, but doesn't completely meet the diagnosis requirements to proceed as "my child has diabetes, this is what I must do."

 

If this is confusing, or if you wish to discuss it further, please pm me. I'd be happy to correspond.

 

ETA: Are there any other symptoms involved, such as wetting, increased thirst, increased urination, behavioral issues?

 

:iagree:

Sorry that you might be going through this.

My daughter presented with "off" symptoms for 1 year before actual diagnosis.

However my son started showing symptoms with a higher A1C and about 7 months later and ever since that time period has been perfectly fine.

Stress and illness can raise blood glucose readings. Anyone can develop ketones if not eating(they are called starvation ketones) or if ill. So it really might have been a fluke.

If you would also like to pm me with any questions feel free.

:grouphug:

[Lawana]

130's before a meal are definitely something to be concerned about. To "stress" his diet, give him juice or soda, and note the results. Dd was diagnosed after a soda, cracker and pretzel snack led to a next morning fasting blood sugar of 301, with large ketones.

Lawana,

 

The 130s were before a meal. On both Sun. and today, I decided to check his pre-/post-lunch levels. Tomorrow I'm going to check his pre-/post-breakfast levels, to get more variety in the data. The pediatrician also wanted me to "stress" his diet and see how he did with a big fast-food lunch, etc.

 

I'll pm you. Thanks SO much for responding!

[mamato3 all-boy boys]

To "stress" his diet, give him juice or soda, and note the results. Dd was diagnosed after a soda, cracker and pretzel snack led to a next morning fasting blood sugar of 301, with large ketones.

 

That is super helpful to know. I'll definitely try to see what happens with something like this.

[vettechmomof2]

130's before a meal are definitely something to be concerned about. To "stress" his diet, give him juice or soda, and note the results. Dd was diagnosed after a soda, cracker and pretzel snack led to a next morning fasting blood sugar of 301, with large ketones.

 

:iagree:

We always used orange juice for this. But neither of my children drink soda so it was also our only choice.