Should I be concerned about high postprandial numbers?

Question

My daughter is 4 yrs old and of normal weight. I am worried about Type 1 diabetes. We have done many tests and seen many doctors. Noone is quite sure what is going on with her. She currently is not overly thirsty or peeing alot, but is this way occassionally. We have seen 14 blood sugar readings over 200 in the last 6 months. They are not fasting numbers, but postprandial (after meals). Sometimes they are 1 hr. after a meal or sometimes 2. They do always come back down to normal eventually.

Should I be concerned about these numbers? Does the fact that she has no other symptoms right now mean that this is just how her body is? She spikes a high bg after eating, but then insulin kicks in and she is OK? Is that normal or do you think it is a sign of impending Type 1 Diabetes? Thanks.

We have seen an endocrinologist who blew everything off because all of our high readings were on a home meter. She passed an OGTT on a good day and that made them ignore everything too. She really does have good days and bad days. I don't think the spikes over 200 are good either, but I can't seem to get it documented "officially". She has had a few high numbers in the dr. office with a finger prick test--that is what started all of this, so it isn't just me that is checking her unnecessarily. We have been instructed to monitor things.

Answer 1

Even in diabetics, the post prandial BG is not as important as the pre prandial. Her sugars could indicate a predisposition to develop diabetes, but there's no way to tell for certain. If your doc's not overly concerned, I wouldn't be either. Just be sure to encourage good lifestyle habits

Answer 2

Yes - post-prandial or after meal readings do indeed matter - very much so. I am very troubled that you have seen 'many doctors' and that your daughter has 14 documented readings above 200 mg/dL (11.1 mmol/L) and the physicians have not made a diagnosis of type 1 diabetes. The range of glucose for a non-diabetic is rather narrow - 70 to 140 (3.9 to 7.8) - and this is not just fasting. This is the range day in and day out 24 hours a day even after large meals or meals containing large glucose (sugar) loads. The non-diabetic never approaches 200 (11.1) unless there is a medical reason. I am very sorry to tell you this but unless your daughter has some other medical condition which is elevating her glucose she is indeed a type 1 diabetic. Prompt diagnosis and aggressive treatment is essential. The good news is that for the past 5 years or so new insulins have allowed us to achieve levels of control in diabetics never before imagined. Insulin pumps continue to be improved. Having seen many doctors who have failed to diagnose and treat a serious medical disorder I do not know how to tell you how to find a physician who knows what they are doing. The quality of medical care in the United States has declined precipitously in the last 2+ decades and although our decline seems to have plateaued we no longer rank in the top 25 nations in the world. My suggestion would be to obtain a copy of your daughter's medical records as this will be invaluable to the physician who sees her. Make an appointment with an Endocrinologist or call your County Medical Society and ask for a recommendation for a Diabetologist. I wish you and your daughter the very best of health and may God bless. If I may be of further assistance please let me know. [e-mail]

Answer 3

You had a full bodily, but do you know for a incontrovertible fact that your health care provider verified your fasting glucose or A1c? 123 mg/dL is on the excessive end of the pre-diabetic range, which is one hundred to one hundred twenty five mg/dL. 126 mg/dL and greater is considered diabetic. I do think it can be intent for problem and you should make an appointment together with your surgeon as quickly as viable to get verified for diabetes specifically. Ask for a fasting glucose and an A1c. The A1c offers you an approximation of your blood sugar typical during the last ninety days or so. Your father's meter might be broken, the strips unhealthy, your hands contaminated... Simply so many variables that might have artificially raised the studying, so that you must an professional test. Additionally it is feasible your father's meter read you low and you were considerably higher. Again, the house glucose meter is satisfactory for diabetics to make use of for self-monitoring, but they're no longer correct adequate for diagnostic purposes.

Answer 4

Yes, you should be concerned. A "normal" blood glucose (BG) reading is about 80-140. Even after a meal, her BG shouldn't be over 200.

Take her to an endocrinologist or a doctor who knows about diabetes. It's frustrating to think that you've seen "many doctors" and they don't see a problem.