I have a dr apt in a few hours later for my son. I tested him a few hours after he went to bed and he was at 150. I told the dr. and she said to bring him in and they will do a urine test. I asked what about a blood test for antibodies and c-peptide and she said we do the urine test first. I countered with what if he’s honeymooning and it comes back clear. She said then go home and bring him back if it gets worse. Is that standard? Should I push harder for bloodwork. Overall his pediatrician is great so I’m surprised to hear this from her
“Bring him back if it gets worse” ?
“Oh, that’s just a simple fracture. Come back if you break something else, and THEN we’ll fix it.”
I would ask her, sarcastically, how much worse? 10 points? 20? What is your cutoff? When is it no longer safe to just let him continue as is? How much hyperglycemia do you consider too much?
Good luck at your appointment…
I would hope that they might do a urinalysis, spot check glucose levels, maybe spot check a1c… And proceed from there wherever the evidence takes them…
They wouldn’t be honeymooning unless they had started insulin therapy… Urinalysis alone isn’t adequate as a solo test because urine can be clear until people are well into harmful territory… At the minimum they shout be finger poking him and checking his glucose levels…
I wouldn’t expect them to be ordering autoantibody panels before a person had been diagnosed with diabetes… Kind of a first things first scenario… And really their only value is to distinguish between type 1 and 2 in cases where it’s difficult to determine… So no I wouldn’t really expect them to be high on any pediatricians list…
Good luck and please let us know how it goes
I am assuming that you have Type 1 diabetes. Has your son been tested through the Trialnet program? As the child (or grandchild or sibling) of someone with Type 1, they will send you a kit and you can have the blood drawn at your child’s doctor’s office. They will test him for antibodies and if he has them, they will follow him and possibly ask to have him enrolled in a trial of possible medications to slow down the autoimmune process. They are learning so much about the onset of T1 diabetes because of the data from Trialnet.
i would be pushing for comprehensive testing.
Make sure he’s eaten a good carby meal before the visit. insist on hba1c. do a glucose finger prick in front of her. hopefully blood sugars in 200+ range will convince her the seriousness of this situation
things can go from not to bad to dka in, very short time in a kid. maybe she wants him in dka before she takes action!! I’d be wanting to see a pediatric endocrinologist sooner than later.
look into type 1 grit group. there is evidence that early and aggressive normalization of blood sugars can delay progression as well as ensure normal growth and development.
My bs was higher than your son’s bs and I only had a trace of ketones. My GP thankfully ran c peptide which was low end of normal and GAD which was over 1900. So I was normal by t2 standards but was diagnosed quickly with type one or 1.5. I would push for gad testing at t because c peptide won’t do much if he’s still honeymooning. I was within normal range. And yep. I’m definitely type one. Good luck.
If the OP’s son indeed has Type 1 (and I suspect he does with a several-hours postprandial BG of 150 [6-hour postprandial number was listed as 160 in another post, if memory serves]), I believe he is not eligible for testing through TrialNet. My understanding is that TrialNet tests only the biological siblings, half-siblings, and parents of children diagnosed with Type 1, but only up to a certain age (I was 55 years old when my then 11-year-old daughter was diagnosed with T1D, her father was 63 years old, and her half-sister was 24 years old; all three of us missed the age cutoff for TrialNet participation).
I was surprised to learn the following at my daughter’s most recent endo visit in late June. When I asked which Type 1 autoimmune antibodies she tested positive for and what her C-peptide level was at diagnosis, I was told that “when the diagnosis is obvious” antibody and C-peptide testing is not always performed. Although a little disappointed, I can understand this. Those are expensive tests that I’m sure health insurance wouldn’t cover unless requested and absolutely effing necessary. And I have absolutely no doubt that my daughter has Type 1 diabetes.
Sam is correct; the OP’s son is technically not in the honeymoon phase as it is medically defined as the period of time when some of a PWD’s beta cells resume production of some endogenous insulin after they have recovered due to the administration of insulin. A person with T1D does not “test negative” when they are honeymooning.
However, I would insist on a BG level (either fasting or not) to determine whether the OP’s son has an elevated plasma glucose level.
The pediatrician pricked his finger about 4 hours after he had lunch and it was 95. She also did a computer urine analysis and said he had zero glucose in it. I asked if this could be the result of honeymooning and she said not in kids, he would have some glucose. My wife realized that she didn’t wash my sons hands before bed and he had a bunch of strawberries so maybe that contributed to the high sugar? I washed his hands before bed and will test him later. Hoping that its a low number. Perhaps I jumped the gun a bit. My son is peeing a little more than usual but nothing major.
As noted in my post above, the OP’s son cannot be honeymooning if he has not been administered insulin.
I’ll amend my statement to say that the “honeymoon period” is sometimes defined as the entire period of time when a person with Type 1 diabetes retains the ability to produce any endogenous insulin. However, the term is most often used to refer to the period of time after diagnosis and administration of exogenous insulin which allows some beta cells to “recover” enough to produce a more notable amount of endogenous insulin.
The (relatively mildly) elevated BG of 150-160 you noted on fingerstick could very well be due to your son’s fructose-laden finger. I’m keeping my fingers crossed for you that this is the case. But if it’s not, it’s not the end of the world and your son will continue leading a full, albeit different, life. And if he does have T1D, you’ve come to the right place (this Forum) which offers endless support, knowledge, and wisdom regarding all things D-related.
Please keep us posted!
Thanks. He had McDonalds at 630 so I figure around 930 would be enough time to test him. Hoping for something in the 90s. The dr. seemed so dead on positive he didn’t have it, but I don’t want to get my hopes up. She said if he had T1 he would definitely have at least a little in his urine, but he had non
I concur that your son would have glucose in his urine, but not necessarily ketones, if he has Type 1.
Still keeping my fingers crossed for you guys!
I just tested 3 hours later after mcdonalds. He had fries, nuggets and apple juice. It was 110. I think I’m relieved. Just want to make sure this isn’t honeymooning and in 2 weeks its much higher
This doesn’t surprise me. I think many of us diagnosed with very high blood sugar and ketone levels as kids never had such testing. I’ve never had antibody or c-peptide testing, yet I have no doubt that I have had Type 1 for the past 25 years, especially considering I’ve since gone on to develop other autoimmune conditions.
Unless he’s been secretly injecting insulin, he can not possibly be honeymooning. In the honeymoon, injected insulin is the spouse.
The testing results so far are great news.
Without going overboard, testing him about 1 1/2 - 2 hours after a carb-heavy meal, occasionally may keep you reassured / catch any problems. Lower carb eating though is probably healthier for everyone, diabetic or not.
That is great news. If I were you, I would still check into Trialnet. If he has no antibodies, you may be able to relax a bit. If he does, you will know to remain vigilant. But don’t drive your poor child crazy.
I was diagnosed in my early 20’s in 1976. I had my children before there was home BG testing. Most of their youth was before the Internet, so it never dawned on me to check their BG. Parents today have a lot more to worry about and at the same time, you have more knowledge and tools to keep your children safe.
My children are eligible to be tested by Trialnet until they are 45 years old. One has been tested and one has not. My grandchildren are eligible until they are 20 years old. They are still quite young and so far their parents have chosen not to have them tested.
Honeymooning ONLY starts after someone is on insulin… there is no such thing as a “honeymooning” undiagnosed T1D, because it just doesn’t work that way.