From Sacramento, California, USA:
A few months ago it was discovered that my son had high glucose readings for two days (over 250's) which then returned to normal readings within a few days. Therefore, his endocrinologist did not make a determination of diabetes or put him on insulin treatment. We have tested his blood daily at home since that time and until last week the readings were all within normal ranges. But then last week they again rose to close to 200.
His endocrinologist has now determined he wants further tests run and will send this back to a lab on the East Coast for testing. I believe one of the test will check for immunology of the pancreas.
I would like your opinion as to what he may be looking for as to the cause of the high blood readings if not diabetes? I should inform you that the high blood sugars were first discovered at the initial appointment with this physician to determine if he had some type of growth problem, as he has not grown within the last year. His TSH tests proved abnormal and he was scheduled for further out patient testing to prove he was not producing the growth hormone, but due to the recurrence of the high blood sugars the doctor has postponed this testing until it is determined what is causing the high blood sugars.
I would appreciate whatever information you could provide. Thank you.
We know that the failure of the pancreas is gradual, and that the blood sugar may not become consistently abnormal until enough islet cells in the pancreas have been destroyed. Immunological tests of antibodies against insulin and the islet cells are usually present at this stage and can indicate that true permanent diabetes is developing and may warrant early insulin treatment to help delay or prevent complete failure of the pancreas.
Occasionally people may have transient mild elevation of the blood sugar lasting 24-48 hours, without ketones, often associated with a virus and may never go on to develop a recurrence of the abnormal blood sugar. Only 25% of these individuals will go on to develop true diabetes (statistics from before antibody testing was widely available.) If antibody testing is abnormal, however, most likely true, permanent diabetes is developing.
An underactive thyroid (as evidenced by the elevated TSH) is very common in children with diabetes. Antibodies against the thyroid may be present. An underactive thyroid is the most common cause of poor growth in children in general. Usually, formal growth hormone testing is delayed until the TSH has become normal with treatment with thyroid hormone as even a mildly underactive thyroid can interfere with growth hormone production in a child who will be able to make normal amounts of growth hormone after the underactive thyroid has adequately been treated.
Very rarely (extremely rarely) hormonal abnormalities can both interfere with growth and cause a mild increase in blood sugar in children who don't have true insulin dependent diabetes (antibody tests for diabetes would be negative.)
Occasionally, children who are developing true insulin dependent diabetes may have negative antibody testing. In this case, only with continued observation will you know if your child has been detected in the early stages of diabetes.
Original posting 28 Feb 97
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Last Updated: Tuesday April 06, 2010 15:08:54
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