Tonight my husband checked our 6 year old after a bowl of ice cream. We do random checks on our children bc my husband is T1 but I also have 2 T1 children. We’re gun shy to say the least. Plus factor in my recent diabetes dx .
She was at 185. Not even 30 mins after eating it. Isn’t that kind of high? Or are the levels ok for a child her age? I know with high carb intake a high BG is expected but I was under the impression nondiabetics normally go no higher than 140. Maybe I’m just too worried???
You have every right to be worried, as her mother. I was discussing exactly this with my daughter’s immunologist / allergy doctor yesterday.
Children’s blood sugars should run lower than adults. Persons without diabetes will rarely run higher than 120 - 140, though typically (if one believes Bernstein), the would not differ too far from fasting.
I think this single observation should not be enough to panic over. On the other hand, I do think it could warrant further investigation. In the past my daughter had a previous Hba1c of 5.6, and random and post eating blood sugars getting close to 200. I saw a pediatric endocrinologist and she told me not to worry, but to observe from time to time. So I have just been observing (quite rarely lately).
The immunologist wrote me an order for hba1c for my daughter (as she emphasized regular monitoring is important), she also recommended checking from time to time (as in a few times a week). Note: my daughter is currently on inhaled steroids for asthma and we want to see if there is impact from this, which is rationale for a bit more frequent checking. I’m hoping my worry is for nothing too. We are also eating low carb as a household. I’m generally following typeonegrit approach to eating for both my girls.
Maybe check her fasting blood sugar a few times and see if it looks normal (reassuring). Then check her post eating (after carby meals) a few times at about 90 - 120 minutes and see how it looks. Once you’ve done a bit more checking you may either be reassured (I hope) or you will clearly know if some more investigations may be warranted.
I’d have a low tolerance level with your daughter’s elevated BGs and would get TrialNet testing and take her to see a pediatric endo sooner rather than later. DKA can occur quiet suddenly in children. Not worth the risk.
Thank you Rose. We’re being referred by our immunologist / asthma Dr to endo for work up for possible early type 1. Wish we could stay with her, she’s one of the smartest women I know, and has been 1 of my doctors for about 15 years. Not happy about this journey. Today I also found out my kids’ fathers’ wife is diagnosed with bowel cancer in early 50s. Gutted for her too. She’s a great person. Don’t know grade yet. We watched her mum die of bowel cancer too, what doesnt seem like long ago. Oh my, what a day it’s been. I’m drinking a gin and lime (sugar free) and just want to cry.
I’m so sorry! You sound like you are having a hard time like me. My 11 year old was dx in June with T1, then my 13 year old in September, me this January and now February with my 6 year old having issues. It comes in droves it seems. I’m glad you have been on top of things with your baby. I’m hopeful things will be ok for your family. Many hugs and prayers for you!
She’s never heard of Bernstein, seemed sceptical, but she did give me her email address and at least didn’t refuse when I said I’d email her info.
Based on ada standards, my daughter is impaired glucose tolerance. She said ‘shame’ we didn’t test before starting low carb 8 weeks ago because she might have been diagnosed at that point.
She doesn’t object to low carb (and doesn’t believe the approach of eat what you like and cover it with insulin), so long as my daughter is growing appropriately and not losing weight. We discussed protein guidelines. She believes diet is critical basis of management.
We’ll be monitoring hba1c closely and any upward trend will result in insulin initiation (starting with basal because my daughter’s fasting is already close to 100).
She did say that high blood sugar in a child can have no other cause but diabetes (though again current levels don’t allow diagnosis when following ada).
She brought up and we discussed types of insulin to start with. She usually starts with lantus, but seemed open to using tresiba or levemir.
Said she would usually hospitalise a child newly diagnosed with type 1 to learn about insulin and management. But that given my experience that may not be necessary. (Her bringing this up indicates to me that she thinks type 1 is the direction we’re heading in)
Talked briefly about Mody, as a possibility for me (and thus maybe my daughter) with ‘milder diabetes’ on fairly low doses of insulin, and with apparent very long honeymoon period (no testing available here so this is just speculation). She was surprised my management was so good. I told her I eat carefully and if I don’t I will regularly see close to 200, even with insulin.
Repeat hba1c, also test insulin levels, c-peptide, glucose in about 6 weeks. She will see her at least every 3 months after that to monitor.
In meantime we are to monitor fasting glucose every second day and 2 hour post prandial also several times a week. Reiterated this, several times.
Contact her immediately if things worsen, or change, or we notice any new symptoms.
We’re doing antibody testing. If positive this may also swing the balance to starting insulin earlier.
Overall good outcome. I can work with this lady.
I’ve got the freestyle libre set ordered and on the way! It’s not available in. Philippines, but I’m getting it from Hong Kong. She’s ok with us using that.
That’s great! That you got some answers. I’m sorry it’s looking like T1 but at least you caught it! I’d only wish I had caught it early in my boys. Even when my second child was dx, I was later than I’d like to have caught it. Given that I had one child and a husband with T1 I felt as if it should have been second nature to me, but it wasn’t. Many hugs!
Thank you for posting this. I’m wondering how families with multiple diabetes diagnoses manage the data. Can your watches or phones switch between users? In particular, how do you parents monitor both your blood sugar and your children’s simultaneously?
Easy in my case. I don’t have a cgm. For me personally, I don’t think I need it because I can get good enough control for now without it.
For my daughter, we are still early days. I’ll be getting a freestyle libre for her later this week, and we’ll probably be using this intermittently for the next few months at least, depending on what we see happening with her blood sugars. IF necessary I will then be using it with her longer term once we start insulin with her.
Neither of my boys or my husband are on a CGM. For my boys while at school I communicate with my younger son’s teachers via texting and my older son’s via texting on his phone. This has been a good method for us. Usually for my husband if he needs my input he’ll just ask. As for myself, I wear the dexcom sometimes to watch certain things but other than that I just go by my meter. Having 4 diabetics in my house can be overwhelming at times, especially when I’m the go-to person to figure up insulin, ESPECIALLY at supper . Everyone’s insulin to carb ratio is different and I’m just like UGH! BUT we manage. I’m considering a big bag or something to tote, that way when we all leave the house we’ve got one bag with insulin, meters, glucagon, etc. all together.
Sorry if you mentioned this elsewhere but has your daughter been tested for antibodies yet? I think that antibody labs can show a positive even on a low-carb diet, which could help get the right diagnosis sooner.
We’ve tested the Anti-Gad already and expecting results some time tomorrow, or soon thereafter. The other two I have not yet found a lab that will do them (more research on that coming up)… Need to make some calls… which I must now do, because apparently they only run these tests once or twice a month.
I’ve got her now on the Freestyle Libre (starting yesterday). We’ve seen numbers from 90s up to 136 so far, which are considered within range (though on the higher end), however, this is on low carb eating… After a few days of baseline, we will challenge with carbs and see what happens.
.
. Everyone’s insulin to carb ratio is different and I’m just like UGH! BUT we manage. I’m considering a big bag or something to tote, that way when we all leave the house we’ve got one bag with insulin, meters, glucagon, etc. all together.