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Hi everyone
My son is 9 years old. He got his regular pediatric exam about 3 weeks back and doctor, whom we have been seeing for a decade (incl for my daughter), rated his health as excellent. He has no weight loss or disproportionate gain, has no urine issues, no excessive fluid consumption, has no signs of fatigue (plays everyday for a couple of hours), is active/alert/happy through the day, and excelling at his school plus other learning/fun activities. I understand that sweets consumption does not cause diabetes but he is totally not into sweets beyond an occasional ice cream or chocolate, something I will classify as low-moderate quantity for a child.
Only issue he is having is bad allergic reaction to some insect/mosquito bites that have caused hives over his body. He gets is a couple of times every year and is on standard antihistamine Montair LC, which contains Levocetirizine and Montelukast, for about 8-10 days now.
I got a full body blood panel done for him as an annual healthcare thing. It was not asked for by an health practitioner. His results were:
Fasting - 222
HB A1C - 6.9, estimated blood sugar level (eAG) is at 151
Tested using Accu Chek kit at home - 430. This was around 1.5 hours after having some cereal + milk and light playing session
Every single parameter of CBC, KFT, LFT, Lipid Profile is spot on other than mildly elevated LDL plus marginally low Sodium and Chloride
Right now, he is completely comfortable and has no clinical issues at all. Doctors have recommended some more tests tomorrow. TTG (my daughter has celiac), repeat of sugar and HBA1C, urine routine, TSH.
What’s going on with him? What could be the reasons? I have been searching the top reliable platforms for information but it has not yielded any results.
Thanks so much in advance. I have benefitted immensely from this forum in the past and hope to get some knowledge in this precarious situation I am in.
@rrag
Get more tests done. ASAP. High blood sugars can be the sign of type 1. He just might not be sick enough yet, to be sick enough? A lot of children find out by going into DKA first, He might still be making enough insulin to keep him well. That might not last long and you need to watch for the signs of DKA.
However some medications can cause an increase in blood sugar levels. Steroids are notorious for that. Sometimes to the point they can damage the pancreas and cause what might be being called type 3 diabetes. Sometimes it temporary and sometimes it lasts. Rare really, but it happens. When you are sick or have allergies it can increase your Blood Sugar levels when you have diabetes. I don’t have a clue on a “normal” person.
Covid is causing diabetes of both forms. With Sars it was mostly temporary, I don’t think they know enough if it’s temporary because of time elapsed yet when you’ve had Covid. Covid messes with the blood sugar pathways in people.
So you need an antibody test and a C-peptide test. An antibody test if positive is a sign of type 1. It shows that your body is attacking the beta cells that make insulin. A C-peptide test shows if you are making insulin still and how much. Low or low normal shows a lack of insulin and is a sign of type 1.
If he shows any signs of DKA take him to emergency, it happens fast. You could get ketone urine testing strips to see if he is throwing ketones, it’s a sign of DKA. Relatively cheap about $10 at a drug store.
Ignore the site saying the less common tests for type 1 is antibody and c peptide as they really are the most common now. But this site lists the tests.
This is often how type 1 presents. He’s totally fine, and totally not fine a short time later.
No possible way you can allow him to have high sugars like that. He is at risk for DKA.
Taht is pretty much how I ended in the hospital, I was losing weight, but I didn’t really notice, I was tired. Thought I had a long fight with a bad cold, but that was all.
Then it hit me I was very sick. Went to the ER, I was 609 fasting. Admitted to the hospital for 5 days.
DKA hits fast and hard and it’s nothing to play with.
If you can’t get movement with his doctor, go to the ER and tell them his sugar is over400
Those lab results are not good.
Why isn’t the Doc doing follow up on that?
If your concerned about the validity of the results, you could have them done a 2nd time at another lab to verify, but don’t wait too long and be sure to schedule an appointment with the Doc to discuss right away.
Celiac disease and type 1 diabetes are sometimes found together. With your daughter having celiac disease, it seems like there is a higher chance your son has type 1 diabetes. You might want to test your daughter for type 1 diabetes too.
He needs ketones checked ASAP (you can buy urine strips over the counter), and if present in any large quantity, I would go to the ER. If not present or trace/small, you can probably wait until tests tomorrow.
T1D can hit hard and fast seemingly out of nowhere. Neither of those antihistamines are steroids, so they are unlikely to be a factor. Unless all of those tests were lab errors, your son most likely has Type 1 diabetes unfortunately. You would not necessarily expect anything else to be off besides blood sugars at this point, but unchecked high blood sugars can put someone at risk for diabetic ketoacidosis (why testing the ketones is important), which can throw off blood chemistry (for example, low sodium can relate to high blood sugar) and cause a lot of very serious problems. I would imagine your doctor wants to repeat tests tomorrow to confirm accuracy, but will then make a diagnosis if the same results come up and then get your son a referral to a pediatric endo ASAP and on insulin immediately.
All the above seems like good advice, I’d only add that the A1C is bad but nearly as bad as if he were running constant BG’s over 200 or more. He’s hitting those numbers as spikes, but the A1C (which is an average) indicates he’s not staying up there. YET. Which would possibly explain the lack of prime symptoms, particularly urination and thirst, which are a result of spilling ketones and that’s what causes DKA. Most don’t start shedding ketones at A1C 6.9 levels, but those are storm clouds you’re seeing on the horizon.
Which is another way of saying don’t take the lack of symptoms as a reason not to be concerned. Get the tests sooner than later.
