Extremely worried please any advice

[ExtremelyW0rried]

hi

Sorry this may be long.

I am type 1 and is is my dad (LADA in all likelihood). I have two children. One is aged 8 and the other is 19 months. So we have two generations of type 1 already

I keep an eye on my children and picked up trace glucose in my daughter's urine after she had eaten some grapes. I checked her sugar and was 5.7. She is 19 months.

I am very anxious around my daughter anyway as she is something of a miracle and she was prem. this happened at the start of the week so this week I've kept a very close eye on her.
Fasting sugars are all good. 4.6, 4.4 etc

One hourly sugars after eating seem ok - usually around 6 and 2 hourly back to around 5.5 or lower. Often at 4.8.

BUT very high glucose things such as grapes, fruit juice, biscuit etc cause an immediate high spike. So today she had a small bar of chocolate after her tea and after 10 minutes she was 9.5, but at 20 minutes she was at 6.0 so the drop is fast.
I am concerned this is the start of type 1. For sure the spikes are short lived and do not seem to happen with carbs, just with high glucose foods.

She is very overweight. That is the other factor. Not due to what she eats but because until recently she had a lot of milk, formula and breast milk. I have cut this right back. It is my fault she is overweight because after she was prem and lost weight they put the fear of God in me about her being small and now she is too big. She needs to lose about half a stone which is a fifth of her body weight. Could this be causing a degree of glucose intolerance / insulin resistance? Or am I just kidding myself because I so badly don't want her to walk this path, particularly as she is so very little.

Any advice? we are on holiday currently and due home Monday. She isn't in any immediate danger so we won't do anything until then. Plus she couldn't be medicated or anything anyway could she? She'd be hypo. I have been basically putting her on a low sugar diet but I don't want to mask it. She should be able to have a handful of grapes or raisins and be ok, right?

I'm out of mind with worry. I'm so distracted by it and concerned. My own dad thinks if anything it is to do with her weight. I cannot find much information on how high sugars can rise immediately after eating something high glucose in non diabetics.

 

[ExtremelyW0rried]

Oh and a biscuit and some apple juice sent her to 8 but mintutes later she was back to 6.3

 

[LittleGreyCat]

I am not sure that your testing should be giving you cause for concern. Your daughter seems to be showing a fast insulin response and maintaining normal BG levels.

I can appreciate that you are feeling very worried and protective and probably a bit guilty as well as your daughter was premature. You have fed her up because she was under weight and now you worry that she is overweight.

Try not to change things too dramatically; take a deep breath and wait until you can talk to your health care team.

Easy for me to say, of course, but I do wonder if you are worrying about the wrong things?

Being over weight is normally associated with T2 and an immune response is associated with T1 so I am not at all sure how diet and weight relates to developing T1. However don't listen to me on that topic; chill pills and relax a bit until you can talk to your HCPs when you get home.

 

[azure]

I totally understand why you're concerned @ExtremelyW0rried but I don't think you need to be.

I would tend to agree with your dad that maybe she's having a slightly increased response due to her excess weight. But, having said that, I don't think her numbers are cause for immediate concern. Non-diabetics can spike up to around 10 on occasion.

 

[ExtremelyW0rried]

Yes that's what I mean. I'm hoping it's because she is overweight which I can do something about rather than it being type 1 which I can't do anything about!

I didn't think non diabetics would spike over about 8?

 

[ExtremelyW0rried]

Also she had a few grapes - 6 maybe - not loads of Coke or haribo. My worry I guess it what would happen if she had 10 grapes? 15? She wouldn't but that isn't the point really. Would the sugars go above that 9ish it would that be it and the insulin would kick in and she'd come back down?

 

[ExtremelyW0rried]

Thank you for your replies. Probably I do need some perspective on it. If I checked her just two hourly it would all look fine. Even one hourly.

I just worry its the first phase of her pancreas giving up the ghost.

 

[LittleGreyCat]

I don't think many people test so soon after eating.

I have had a very quick look and most results suggest that BG levels are expected to rise about 20 minutes after eating and normalise over 1-2 hours.

Children will react more quickly but so far I haven't found anything about spikes within 10 minutes then back to normal.

 

[catapillar]

The diagnostic criteria for diabetes is a random blood sugar of over 11.1. So it is perfectly possible and normal for non diabetics to have blood sugar spikes up to 11.

You daughters blood sugar levels seem to be a perfectly normal non diabetic blood sugar levels. Everyone, including non diabetics, spike after eating something carby.

If you are concerned about your children and type 1, have a look at the trial net study - http://www.bristol.ac.uk/media-library/sites/clinical-sciences/migrated/documents/factsheet.pdf

 

[ExtremelyW0rried]

I could get my son tested but not my daughter until she is 3.
I don't know if it's better or worse to know if they are increased risk or not? If I knew they definitely were it might make me even more anxious.

My daughter definitely drops back into range quickly but it seems that some high glucose foods give her a spike of around 9. Not ice cream interestingly. Being away she's had a few and they have caused her no problem.

Usually she has some wholemeal toast with peanut butter for breakfast and some strawberries

Lunch she usually has a wholemeal cheese sandwich, maybe an omelette or soup and some more fruit or yogurt.

Dinner is usually spaghetti bolognaise or a roast dinner with vegetables or quiche.

Snacks used to be grapes or raisins or a banana or biscuit or apple but I'm stopping the higher glucose things. She doesn't drink much fruit juice ordinarily. It is definitely the milk that has made her too fat. She didn't really cut it back after she started on solids. Well I didn't cut it back I suppose. Not her. It's my fault not hers.

 

[azure]

If it's going to make you anxious, I wouldn't test personally @ExtremelyW0rried

Watch and be aware, but don't let the fear spoil your enjoyment of your children and life.

 

[LittleGreyCat]

Just found another interesting reference
https://www.diabetesselfmanagement....blood-glucose-management/strike-the-spike-ii/
which suggests
"Preschool-age and toddlers (5 or younger): below 250 mg/dl" which is roughly 13.0 mmol/L.

If this is accurate (and don't trust anything on the Internet including me) then you have no worries.

I would expect young children to react in a very different way to pre-teens, teens and adults.

Anyway, she is fine at the moment.
Deep breaths and chill.

Edited to note that I agree with @azure ; you are probably getting yourself all worked up by testing so much. Brave little girl with her fingers all pricked.

 

[ExtremelyW0rried]

I think that 250 is target for diabetic children though...

She seems to spike higher than you'd expect but it comes back down more quickly than you'd expect too.

 

[LittleGreyCat]

I suspect that not testing until your daughter is 3 is an indication that BG levels before that aren't an accurate indication of anything unless they are way high.

At what age were you diagnosed?

 

[azure]

I think that 250 is target for diabetic children though...

She seems to spike higher than you'd expect but it comes back down more quickly than you'd expect too.

The 11.1 diagnostic level is the best one to look at.

Your daughter's BS returns to normal quickly

 

[Rachox]

I can understand your extra specially anxious about a SCBU baby, my son (now 21) was in SCBU too, and we were very protective of him when he was little. However, having been reassured by the above comments, my overriding response now is poor baby, no more finger pricks! I understand how scared you must feel but if she's not showing symptoms and you didn't have a monitor you'd be none the wiser. Try to enjoy the rest of your holiday and let your baby have her ice creams

 

[ExtremelyW0rried]

Yes it does and I don't know if it can be normal to spike to that level if it is a high glucose food. I cannot find any information on it.

 

[ExtremelyW0rried]

Luckily she doesn't mind the blood test. In fact she can do it herself and then she does mine.

In fact if I do mine and she doesn't do hers she appears and says my turn.
However just because she doesn't mind it I know isn't a reason to do it! If it distressed her in anyway I wouldn't do it.

 

[ExtremelyW0rried]

Oh and I was 11, nearly 12 on diagnosis.

My dad was an adult and didn't take insulin for 5 years. Sometimes they tell him he is type 2 but he doesn't really fit that either. He takes a lot of insulin now.

 

[Bluetit1802]

I'm not qualified to comment on any of this, but the foods making her spike seem to be fruits - grapes, raisins, fruit juices. Speaking purely as a diet only T2 adult, I can say these fruits and fruit juice would spike me a lot, and they are quick release carbs so will spike early..