Could this be type 1???

[Rpierson6507]

Just wondering could this be type 1 developig? My son is 3 1/2 and has been experiencing low blood sugar since July 2017. He would wake up and be lethargic, crying/winey. And not want To eat or drink anything and then would get really sick and vomit multiple times. One time we decided to test his blood since my husband is t1 (diagnosed at age 12) and so is my father inlaw and sister inlaw. When we tested my son that first time it was at 56 and we immediately made him eat some candy and tried to get him to drink juice (he refused). His blood sugar cane up and he was fine. Those low episodes happened about once every week for about 3 months and his pediatrician told us to just make sure he eats more carbs before bed. So we did. At that time his A1c was checked and was at 5.2. The episodes eventually tapered off and only occurred every 3-5 weeks and we weren’t so worried until just recently approx March 2018. In March he ended up getting the flu and after that we noticed he was peeing ALOT and drinking a lot. He even began wetting the bed occasionally which he’s hasn’t done in over a year (he’s fully potty trained). We began testing his blood again then. His fasting bs was at 138 one morning (which is high) and then a few other times it’s been either low (under 65) or once again high (above 126 fasting for 12 hours). We also started testing him 2-3 hours after meals and he would be above 140 sometimes as high as 198 (that was the highest). Then this past week he woke up sick. We though he was just tired because he didn’t get to bed till 11 the night before (bedtime is 8:30) and so we brushed it off the next morning (8am) when he wasn’t acting quite right. Well then at 10 am he still wasn’t and he began vomiting so we tested him after cleaning him up and his sugar was at 61. The night before he had steak, green beans, 2 pieces of bread (about 15g carbs total), 1 apple sauce cup, and 1/2 cup Mac n cheese. He ate all of it except for some steak, a little bit of apple sauce,  and a few green beans.  To correct his low blood sugar we gave him 1 serving of gummy bears (15 g carbs) and waited 15 min then gave 1 more serving of gummy bears. And then tested him 2 hours later. When we tested him he was at 181. Isn’t that a bit high for waiting 2 hours and all he had was 30 grams of carbs? We brought him in today for a fasting glucose and an a1c so I guess we will see what those say.
I’m just so worried about him and feel like his pediatrician doesn’t care about our conserns. She attributes the vomiting in the morning to cilic vomiting syndromes and says that the low blood sugar has nothing to do with it.

[Super_sally888]

Hi,

I would share your concern that your child could be developing type 1 diabetes.  Children's blood sugars are typically lower than adults, and a result in the high 50s or 60s can be 'normal' for a fasting level.  People without diabetes (or risk for diabetes) will typically never go above 120 (and usually their blood sugar would be tightly controlled in a narrow range all the time).  The highs that you are seeing are concerning, particularly that he didn't have much carbs.

Putting him on a high protein, lower carb diet, with adequate healthy fats for energy may help avoid the highs and also help keep his sugars stable.   Given that his lows are not 'very low" for a child, you may also try using less glucose for treatment (ie. just 1 - 2 grams, not 15 grams), and then follow this with a small protein snack.

Please request his doctor to do antibody testing.  They should also testing c-peptide, and insulin levels.  

Given his family history, you could also look up "trialnet", and then contact them.  They will conduct testing of children of relatives with type 1.  It is part of a large population study.   They test for about 5 different antibodies and there are prevention / delay diabetes trials also being run.

I would suspect that he has early type 1 diabetes, and you are watching this develop 'slowly' over time.  

Please check out Bernstein Diabetes University on U-tube.  They have a lot of information and also "what to do" if your child is developed with type 1.  They do use low carb, high protein diet as part of management.

Please let me know how you go.  You may also message me, if you need further support.