[hpracing25]

OK, so on March 26th, I took my five year old daughter in to her regular doctor for a weight check (She has always been small, and her doctor has been keeping a close eye on her weight the last few months) She had lost four pounds in a month, she is now down to 34 pounds, so he did a bunch of blood work on her, and everything came back normal except her random glucose, it was 234! She has always been a thirsty child, but recently started peeing in her pants. She has also been really tired. So, he did an A1c, and it came back as 5.5%. He wanted her to go to a pediatric endocrinologist, and we thought it was all set up, then the endocrinologist called me at home a few days later wanting new blood work through the doctors office, so we took her back in on the 30th of March, and her doctor re-did her glucose, it was 148, and he re-did her A1C (I didn't figure the A1C would change, but it was 6.3%) So, he gave us a scrip for a meter, and strips, and we were told to start checking her sugar three to four days a week, fast forward to today, we have been checking her sugars, and they range anywhere from 40-300 at times. We have been to the ER three times in less than a month for highs and lows, now Friday, her regular doctor saw her again, and took all her logs and faxed them to the endocrinologist. What I am confused about is, first, is it even possible for her A1C to jump that much in just four days? Why is the endocrinologist dragging their feet? Is it normal for a non-diabetic child to have such wild ranges of blood sugars? One day last week, she started out fasting at 224, then before supper, it was 130, then after supper, before bed, it had bottomed to 46. This just doesn't seem normal to me, am I wrong? Any help would be appreciated, and thank you all.

 

[Shanny]

She needs to be tested for GAD antibodies to determine if she has type 1 diabetes, and then she needs to be tested for c-peptide, to determine what small amount of insulin her pancreas is still making. And if one of these doctors doesn't step up to the plate pretty damn quick, you must go over their heads to the chief of staff or whoever it is that has some authority, and insist that your child get the treatment she needs. A non-diabetic child does not register blood sugars ranging from 40 to 300, and does not lose a pound a week. She's already exhibiting some classic symptoms, and if she gets weak, confused, short of breath, abdominal pain/vomiting, etc., get her to ER as fast as you can.

http://emedicine.medscape.com/article/907111-clinical

 

[Patdart]

Shanny is on top of it! Good luck! Keep us posted, please....

 

[jwags]

In adults normal glucose is 70-100. Children may be a little higher but not much. If her pancreas was producing enough insulin she would rarely go above 100 . As Shanny said she needs to be tested for Type 1 Diabetes with a GAD Antibody Test and a C Peptide test. Don't let the doctors drag their feet. At her age she is probably a Type 1 diabetic or possibly a MODY Diabetic. With numbers above 140 she might need insulin to bring them down. HbA1c's are averages of bgs over 3 months. They shouldn't change that much in a few days but different labs could have variables.

 

[Guest]

Hi hpracing25,

What Shanny said!!!

I worry when you say "We have been to the ER three times in less than a month for highs and lows" and want to ask what happens at the ER? Do they give your kiddo insulin to correct the high, or glucose to correct the low?? I can't say why the endo is dragging feet on this, but I can suggest that a five year old with glucose of hypo and hyper ranges is pretty indicative of T1 diabetes and your kiddo needs to be treated as such and not put on hold.

Repeat of what Shanny said...She's already exhibiting some classic symptoms, and if she gets weak, confused, short of breath, abdominal pain/vomiting, etc., get her to ER as fast as you can.

I hope your daughter gets the treatment she needs, and I wish both of you well.

 

[hpracing25]

Hi hpracing25,



I worry when you say "We have been to the ER three times in less than a month for highs and lows" and want to ask what happens at the ER? Do they give your kiddo insulin to correct the high, or glucose to correct the low?? I can't say why the endo is dragging feet on this, but I can suggest that a five year old with glucose of hypo and hyper ranges is pretty indicative of T1 diabetes and your kiddo needs to be treated as such and not put on hold.

That is the thing, they give her juice for her lows, and it comes back up, and for her highs, they do nothing, they observe her, but they usually go back down on their own after a couple of hours.

 

[foxl]

Your daughter is "honeymooning." That is to say, she is probably losing her insulin, slowly, and they do not want to treat her too early, and send her into a hypo.

I would seek a second opinion, though. Not really familiar with pediatric diabetes, but I think many practitioners believe that using basal in low doses might help prolong the honeymoon.

 

[Nikki Lee]

I was 4 when I was diagnosed as type 1 & was exhibiting many of the same symptoms so if I were you I would follow Shanny's guidelines.

 

[hpracing25]

Update!

Well, for all of you all who are following, we have to take my daughter in in the morning for a fasting glucose test, maybe this will be the test to make the endo agree to see her. LOL, Her morning sugars are creeping up higher each morning, this morning it was 213. So, hopefully, this will be it. I will keep everyone posted as soon as we know more!

 

[Nikki Lee]

Good luck tomorrow just remember if she is diagnosed with type 1 you should make sure to encourage her to believe that she has diabetes it doesn't have her.My parents were encouraged to never treat me differently.

 

[Shanny]

Yep - first rule of order - diabetes is not who she is, it does not define her. She is a child who happens to have diabetes. Thanks, Nikki!

 

[hpracing25]

Update

well, doctor called back today, and her fasting blood sugar was at 64. He said that is perfectly normal, so she is not diabetic, and they think her being high for a while, and her spilling glucose was stress. He thinks she was stressed, and it raised her glucose. Thank you all for the help while I worked my way through this all, and thanks for all the support.
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[Yakfishingfool]

I'm no sure I would leave it at that. Has she seen the endocrinologist? When a thyroid fails it often goes off in a wave pattern with highs and lows. Depending on when you test you could get a high or a low result. I suspect you are seeing the same here. She is failing and it is going off in waves and you are catching it at different parts of the wave. I wonder if it wouldn't be useful to do a solid week of regular diet and activity and test before meals and at bedtime for a truer picture. Just a thought. I wonder if her pituitary is acting correctly. Have they looked at all her systems?? Scott

 

[hpracing25]

Just wanted to update you all. We are in the process of switching our daughter from the family practice doctor she was going to, to a new pediatrician who has more experience with type 1 diabetes. So, we are going to get a second opinion on all of this. Her first appointment is the fourth with the new pediatrician, so I will update again with what she says.

 

[Donella]

Just wanted to update you all. We are in the process of switching our daughter from the family practice doctor she was going to, to a new pediatrician who has more experience with type 1 diabetes. So, we are going to get a second opinion on all of this. Her first appointment is the fourth with the new pediatrician, so I will update again with what she says.

I am so glad you are getting another opinion.

 

[foxl]

One more thing: ER docs are trained in EMERGENCY medicine. Their advice and care is NOT intended to replace the longterm care provided by an Internist or Endocrinologist.

I know more than person (my husband, included!!!) who has relied on urgent care or ER medicine, to deal with what is really a chronic illness requiring very different consideration and measures. I totally understand the assumption that, if a doctor says, "She'll be fine," their word is enough. It is NOT. Many doctors will be reassuring, from the viewpoint of their type of medicine. General Pediatricians tend to fall under that umbrella, as well. Personally I have gotten way too many reassurances from docs who just ... DO NOT KNOW.

 

[furball64801]

Yeah my wife went to an ER doctor 30 yrs ago gave her nerve pills. She delivered a 8 lbs cyst in a week, sure she was fine after it was yanked out. She left the ER crying thinking it was all in her head and she works in the hospital the jerk.