Recommended bsl range for non-diabetic child...

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Recommended bsl range for non-diabetic child...

Postby Rachel » Sun Jun 22, 2008 9:24 am

I am a little concerned for my little 2 year old son whom is NOT a diabetic....

Just this week his nappies have been heavy and he has been asking for water more than usual. He isn't extra tired, distressed or losing weight. I tested his blood sugar late last night 3 hours post meal and his bsl was 8.6. I freaked out and tested again and it was 7.8. Still too high for my liking. I am worried about these results. Does anyone know the recommended range for non-diabetic children? My husband did some research on the internet but I don't trust the responses. It said that infants do run a little higher.

I am hoping to do a morning fasting bsl tomorrow. It was hard work testing him last night. Plenty of tears. I admire any parent with a child with D especailly my parents after only one blood test.

Having had diabetes for 23 years I know the signs and the symptoms and I'm hoping that I am over reacting because this is the last thing that I would want for my boy.
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Postby Bill(OB) » Sun Jun 22, 2008 10:54 am

The signs and symptoms can indicate other things or nothing too.

I am one of those parents who have been dealing with diabetes since Claire was barely 3 years old, and there was little doubt something was wrong with her. Yes, the same symptoms, but writ very large. Drinking like she was dying of thirst (which she was I guess) and flooding the bed through her nappy every night - after almost being night time dry.

Even for diabetic nuf nuffs like us at the time, the symptoms were enough to get some expert advice. If your little one is developing diabetes there will be plenty of finger pricks in the future, and it will be very obvious, as you know, that it is happening. It seems a pity to be traumatising the kid without real cause - or so it seems to me.

Why not just go to your doctor and get him checked rather than fighting the poor little bugger to do BGL tests? Oh and just for comparison, Claire had a BGL of 19.0 at diagnosis.
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Postby Mel » Sun Jun 22, 2008 1:36 pm

Hi Rachel.

I've heard other d parents describe a similar thing, every time their child is thirsty or their nappy is wetter than normal they fear that they have diabetes, which is normal.

One thing to be aware of is that our home bsl meters have a fairly wide margin for error so you can't jump to any conclusions about a reading of 8.6. I know it must be easier said than done, but I tend to agree with Bill if your little one is developing d then the symptoms will become very obvious.

Instead of putting him thru the fingerpricks is it possible to obtain a urine sample and use the ketodiastix, they will show if his bsl has been above 10 in the last few hours, that's painless and just as effective if you're trying to identify diabetes. Not sure if you can get your 2yo to produce a sample though, can he use a potty?
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Postby Catapult » Sun Jun 22, 2008 2:55 pm

I have a non-D step daughter who I freaked out about as she was drinking like a horse and pissing like a pup.

I tested her fingerprick style after a meal and she was in the 8s. We took her to the doc for a fasting glucose which was 5.0 (supposed to be under 5.5)

From what I understand are the guidelines, 1 hour post meal up to 11, 2 hour post meal up to 8 and 3 hour post meal back to under 6.

So far its been a year since the drinking and peeing started and she has gained weight and height like normal and has the usual energy of a child. So she doesn't have D. She just sweats a far bit and needs more water and hence pees more. We have made it a rule to only have water to drink as she was having cordial and juice and the sweetness was only encouraging far more drinking.

Don't press the panic button just yet and freak out your kid with constant fingerpricks. If he does have D, it will show up eventually and ditto what Mel said about the pee stick test. If it has only been a week you probably won't see weight loss.

Cat.
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Postby belinda222 » Sun Jun 22, 2008 6:32 pm

Hey Rachel

I had a similar experience. We are in the Trigr study group with our eldest Daughter (now 3) and because one year we didn't get a blood test done they asked us to do a finger prick at home and submit the results to them instead. It was in the 9's and I totally freaked out, we then kept doing bsl's on my meter and tested her wee. The wee never revealed any sugar but the bsls were all higher than normal. We got a blood test done and it was ok.

The response from the Trigr endo and nurse was that they are having the exact same things from all of the non D kids. They explained that they have never really tested normal (ha ha) kids before so they are not really sure what their bgls should be so when all of the kids were getting high readings they were initially worried but it seems that kids just have higher readings sometimes but it does not really mean anything... anyway she is now three and she has never had any bad blood tests, just weird ones on my meter at home??? normal, but scary for us D mums who are scared that our kids will have to go throught the same crap we had to as kids
Belinda :)
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Postby Mel » Sun Jun 22, 2008 6:57 pm

They explained that they have never really tested normal (ha ha) kids before so they are not really sure what their bgls should be


Wow! That's amazing and interesting on soooo many levels.

The most important being that many parents of d kids are stressing out and potentially risking their kids hypo awareness and psychosocial adjustment to chase a perfect bsl but it might be quite ok for kids to have slightly higher bsls.
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Postby Catapult » Mon Jun 23, 2008 1:29 pm

Mel wrote:but it might be quite ok for kids to have slightly higher bsls.


I think that HbA1c targets are higher for kids and teens than for adults too. So indirectly the kids with T1 will presumably have higher BSLs. I don't know if this is because the 'experts' think too many hypos will rot their developing brains/bodies or if they know that low A1cs are just unrealistic in growing children.

Cat.
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Postby Rachel » Mon Jun 23, 2008 3:47 pm

Thankyou everyone for all your great responses. It is very reassuring to know that my reaction to this situation is normal and it's most likely that I am over-reacting.

I have spoken to an expert and they have said that children do run on higher bsl's than adults as a result of growth hormones. I would obtain a urine sample and have some tests done for peace of mind.

I would assume that if my boy did have diabetes the symptoms would be much more extreme and the bsl's would be in double figures.
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Postby maccas » Mon Jun 23, 2008 7:45 pm

I know it can be worring, I have tested my 3 kids on and off

I remember that my daughter was the same as your little one, soaking nappies and drinking heaps. she had a slightly higher bsl so I freaked, ended up taking her to the dr, all she had was a urine infection, that can also raise the bsl

I ended up having my 3 tested to see if they had the D gene, turns out they are ok, not to say they will never get it but made me rest a bit easier
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Postby Kate » Wed Jun 25, 2008 10:51 pm

Hello everyone -

Have just been having a quick read of the quite freshly published International consensus guidelines on Type 1 diabetes in children and adolescents.

Couple of points of interest:
In non-diabetic individuals, counter-regulatory
systems are normally activated at a plasma glucose
(PG) level of 3.6–3.9 mmol/L (65–70 mg/dL), while
symptoms of hypoglycemia occur at a PG of
3.0 mmol/L (54 mg/dL) and cognitive dysfunction
at 2.7 mmol/L (49 mg/dL) (63, 64) (C, B).



Target HbA1c for all age-groups is recommended
to be 7.5% (E). These targets are intended as guidelines.
Each child should have their targets individually
determined with the goal of achieving a value as close to
normal as possible while avoiding severe hypoglycemia
as well as frequent mild to moderate hypoglycemia.


It gives the following as the "Ideal (Non-Diabetic)" blood glucose levels:
Biochemical assessment*

SBGM values:
AM fasting or preprandial 3.6–5.6
Postprandial PG† 4.5–7.0
Bedtime PG† 4.0–5.6
Nocturnal PG† 3.6–5.6

HbA1c (%) (DCCT standardized): 6.05


And then goes on to give the following as the "Suboptimal (action suggested)" , first numbers below, and "High risk (action required)" numbers, the second numbers in each line below - which are quite different:

Biochemical assessment*

SBGM values:
AM fasting or preprandial : >8 , >9
Postprandial PG† : 10–14 , >14
Bedtime PG† <6.7 or 10–11 , <4.4 or >11
Nocturnal PG† <4.2 or >9 , <4.0 or >11

HbA1c (%) 7.5–9.0 , >9.0

Worth a read:
http://www.ispad.org/FileCenter.html?CategoryID=5
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