He is 12 and yes it was done fasting.
??? Earlier you said he is 13. Either way, I think the post from JohnG is right on...there may be more going on than diabetes. 12 or 13 is a time of BIG changes for a kid. What do 'they' do to resolve the highs in the ER?? At this point I would be less concerned about the type dx, I would find a way to manage the things you do know. Is he testing at home or are these high readings only at doc visits?
Not sure when I said 13 but he will be 13 in February.
Yes we test at home and I gave them his reading. He tested high in the ER. When we got seen he was 309 after 3 hrs he was down to 215 and by 5am he was at 121. They did nothing at the first hospital except send us over to Primary Childrens which was 40 miles away after waiting there for 4 hrs they ran some test said the Endo there felt he was safe to go home and we would get the results of the blood and urine in 3 days.
Back on page 1 - you said. "All this lost me LoL. He is 13 and yes already had a trip to the ER he was at 320 so I went and they did A1c it was 6.8 and a urine had glucose. After 7 hrs his sure went down to 121 so they sent us home."
During that 7 hours they just did tests then? Why did he need to go to ER in the first place?? Does your son have ketones in his urine at all??? I have more questions than advice, sorry.
OMG so many number yes i said 13. I guess i should said 12 but I say 13 at home too.
He went to ER his tummy was hurting again he had a similar episode a few days earlier and his BG was at 304 and he wasn't well then. He laid down a few hours and within 5 hrs his sugar was normal. When it hit 300 the next time I went to the ER like his GP said to since there was still no Endo referral approval. Like I said we got to first ER they said yes numbers in a non diabetic don't go this high after almost 2 hrs they sent us to a different hospital. Who just ran testing. The only test that came back was his regular BG test which was a 121. So from 10pm till 5am his sugar dropped on its own. We didn't have the urine or the HGA1c till few days later. The doctor in the ER said a diabetic will not drop that fast. Not sure what he meant by fast to me that was 7-8 hrs. I am really confused and am not getting answer. Believe me I have tried. I feel like people are saying I need to try harder I CAN'T... Not sure what else I can do. The only test left is the IA-2 which if am correct is for adults not kids. So am playing the waiting game again.
A lot of T1 adults are very slow onset. In my case it was probably over a decade, and possibly 15-20 years before I actually crashed, so I think it is possible that he's moving slowly in the direction of T1. Generally the faster you get on insulin the better because it helps stop the remaining beta cells from getting burned out. I'd probably want him on some slow acting insulin if it was my child, and then if he needed it, I'd add some fast acting for meals.
A1C is too high, C-peptide shows T1 as opposed to T2 and is trending downward as it would with T1, and GAD is very high showing T1. So either he is type 1 or there is some other problem that needs to be diagnosed. However, they haven't found anything else, so he is type 1 and at an A1C of 6.9 damage is being done. IMHO they should at least give him 1-2 daily doses of long acting insulin to get the damn A1C down and put less strain on his Pancreas, so the cells don't burn out. Also, when he does crash, he'll avoid a trip to the ER and possible damage to his body.
it's not an age thing. i don't like the term 'lada' it's just type 1. many children present the same way, they're not DKA, they go into a honeymoon period, etc...and still have viable beta cells...but they're not called lada. also, many adults go DKA and have a rapid onset. i think children typically aren't wrongly Dx'd as type 2, unless they're obese, because children typically get type 1. adults do too but many health care providers don't understand type 1 diabetes or understand that adults indeed can get it. so, many children are slow onset as well and it's not called LADA, just type 1.
I have to tell you, doctors are often not very competent to diagnose T1/LADA. Almost no GP could properly diagnose a T1/LADA if it leapt out into their face. And an ER doctor only makes a diagnosis when it is an "emergency," with a patient that presents in DKA. If it appears that the ER can "stabilize" the patient, they will send you home and tell you to see a doctor.
If you can see an endocrinologist, you should do so promptly. If you can't see an endocrinologist, then go to a new doctor and tell them your son has T1, don't ask for a diagnosis, tell them. Give them the tests that prove your son has all the markers and ask for appropriate treatment for a T1. If they decline, questioning the diagnosis, then demand that they prove otherwise. And demand appropriate treatment for T1.
While I appreciate what JohnG has said that IA2 further "confirms" a T1/LADA diagnosis, the standard of practice is that a T1/LADA diagnosis can be made with the detection of any one of the three antibodies. And a doctor should follow a standard of "do no harm" and to withhold treatment until either IA2 is confirmed or the patient presents in DKA is hardly doing no harm.
See that what I did at first ER I told them he is type 1. They asked why my GP put him on Metforman I said because we are trying to in to a ENDO now that takes my insurance. They said stop the Metforman NOW and we sending you to primary. He needs insulin not a type 2 drug. When we got to Primary Childrens they said no we are running test that our Endo here asked us to do. If he is type 1 we will keep him and get him stable but if signs show he isn't you will be able to go home ans do a follow up with you physician. The only test that came back that day was his sugar test that they took that we do at home at that time which was 7 to 8 hrs AFTER his high he was at 121. They said he is normal. I said ok why was he 300 at ER at 10pm then when we got sent here he was ar 215 I think was now it is 5am he is 121. They said he was fine in few days all get labs back. Few days later i got what I posted in other thread
Exactly what I was thinking Brian! The last place to try to achieve a proper dx is the ER. Has he ever been given insulin? Seems the only thing that happens at ER is lab testing and I can't figure how he gets "stable". Other than lab testing, what do they do in ER to stablize the kid?
Is your son over weight? Is he hungry or thirsty all the time?? Does he need to use the toilet a lot??? Is he active and able to enjoy activity???? He is no doubt dealing with puberty and the bodily changes and emotions that go along with that. I know this is frustrating for you momof4, I can't imagine what your son must be feeling. Poor kiddo.
May I suggest that some sugar testing commence at home and a log kept and bring that to the doc? I would test often... And I'd check for ketones also. Nothing better than showing up at the next visit with some ammo in your purse!
I still think there is something else going on besides diabetes. I think an endo and one that deals with kids needs to be seen if possilbe.
Date/Time Glucose Meal Glucose Factor Notes
10/06/13 9:30 am 152 Before Fasting
10/05/13 8:35 pm 172 –
10/05/13 5:30 pm 146 Before Dinner
10/05/13 8:30 am 147 Before Fasting
10/04/13 8:45 pm 178 – Bedtime
10/04/13 4:00 pm 196 –
10/04/13 7:06 am 154 Before Fasting
10/03/13 8:43 pm 193 –
10/03/13 3:38 pm 98 –
10/02/13 9:00 pm 205 – Bedtime
10/02/13 6:50 am 125 Before Fasting
10/01/13 8:27 pm 146 – Night time
10/01/13 7:00 am 119 Before Fasting
09/30/13 8:40 pm 209 –
09/30/13 7:20 am 134 Before Fasting
09/28/13 8:55 pm 169 – Before family movie time with popcorn,
09/28/13 4:20 pm 242 Before Food going to eat out
09/28/13 8:00 am 133 Before Fasting Didnt eat much in last 24 hrs.
The ER did nothing have us wait. He is 4'11 65 lbs he is very thin. His nick name is bones. Never been given insulin but was on Metformin for 2 weeks and it went down a tad but he got sick. He didn't want to eat and said was not hungry. He is extremely active. Yes hungry all time and he is a fish he drinks a lot water. He goes at least 1x a night a few times i seen hi go twice but he will be 13 soon so I don't really listen for him. usually when he hits 250 i do a test strip in his urine. I always get high reading of glucose and at times i get a small amount of ketones. It is usually the light pink on the strip where the glucose is as deep deep blue. Unless am reading strips wrong I doubt it. As for ammo this is all the stuff I have had on him. I go everytime armed but not one doctor has given me much of answer.
are you seeing a pediatric doctor, he's only 12/13 years old? why and how did you know to test his blood sugars; are you a diabetic, if so..type 1 or type 2? no non-diabetic has blood sugars in the 200's. So, I don't understand this, pieces of this puzzle seem to be missing. why the heck any doctor would not Dx type 1 in a very thin child with a high A1C and blood sugars...i don't get it. Metformin, huh??? Again, this makes no sense. who the heck gave him metformin and why would they suspect type 2? if they don't think he's diabetic (regardless of type, why give him anything then). something doesn't makes sense here.
My son has a half brother who is 17 and is type 1 since 1 yr of age his is BAD. Due to reason I wish not to get in to my son doesn't know his dad and never will. His dad can not harm anyone no more. The only contact I ever had with my sons half brother was thru the ex wife who wants nothing to due with the man nor my son which is fine.
When my son was sick I had to give medical info and that was one of the things and I made sure to carry his medical file from each doctor when we moved states. So the last pediatrician we had tested his sugar since he had a half sibling. It was almost 200 I think was over 2 yrs ago.
You still haven't clarified something, mom, or else I'm just confused. Has your son been diagnosed with Type 2 diabetes and is being treated for it? Does the doctor acknowledge that he is diabetic but just is unwilling to consider he may actually be type 1?
A lot of us have to do a bit of doctor shopping to get someone to listen to us and take corrective action. Seems like your doctors are waiting for it to get worse before they do something, but IMHO with that A1C, it is time to get him on insulin.
Maybe you could try contacting the local chapter of JDRF to get the name of a doctor willing to make the diagnosis...
Thanks, Shawnmarie, I was a bit puzzled why the OP didn't respond to requests for clarification.
Shawnmarie thank you and yes I do feel over welmed. Zoe I answered all questions when I was online last. Read all the other posts it will answer your questions. I keep responding to some of same questions so I try to cover it all.
His sugars arent just high after he eats then are high 2 hrs after also. Like tonight he at 248 2 hrs after dinner and if reading this right has glucose again.
"Has glucose again"??? Huh??
No, you have not answered the question as to whether your son was diagnosed with Type 2 diabetes. Simple question.
I read the post, Shawnmarie. She never clearly states he was diagnosed with Type 2. But bottom line, there is something seriously odd about these threads. A mother who doesn't know if her son is 12 or 13? "We call him 13 at home" (even though his birthday isn't until February) Huh??. I'm not sure what this person's agenda is (though I have some theories) but something is off here. If you took your son to three doctors and they all allowed him to continue on oral meds despite consistently elevated blood sugars and positive antibodies, what would you do?? Complain on a website?