Pediatric Endocrinology Expert Forum
What to expect next?
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Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.

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What to expect next?

My daughter is 4 and has had some blood sugar issues in the past.  We have already seen the pediatric endo. and they have released her back to the pediatrician.  Her A1c's have been ok.  The first one was 5.3 and then it went to 4.9 and a year later the pediatrician ran a random one and it was 6.0!!  I started checking her blood sugars again and while a couple were a tad elevated...the rest were fine.  She spills a little ketones at times but not in amounts to worry too much about.  I thought maybe the last result was due to the lab being different than the first 2 draws.  After asking the pediatrician about this she told me there should not be too much of a difference.  So we are going to wait 3 months from the last draw and retest her A1c.  According to her labs she has 20 JDF units and her c-peps keep fluctuating from .6 to 3.5.  Her GAD is <1.0  We just don't have definitive answers and its hard playing a waiting game.
I am a T1 and pump insulin.  My mom is T2 and her sister and mother are T2's also.
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If you are at a Children's Hospital ask your pediatric endocrinologist about TrialNet, it is an international study that screens siblings and relatives of various groups of populations and can help us find folks susceptible for type 1, there are many studies now while we wait for a cure that are working towards early intervention, meaning if we can stop the autoimmune process early we can preserve the pancreatic islet cells.
Your child has hba1c up and down, get it done at your endocrinologists office or have it sent to the lab only, especially since a lab rather than the machine in the office can pick up unusual hemoglobin types that make the test vary. The endo office calibrates their machine no doubt and knows how to run it. No GAD is good, not sure if the islet cell antibodies are significantly high, what is the range.
So monitor her if you want, fasting sugars are key, if she has type1 it will be clear, if she is more like type 2 or a new kind called mody we may see higher readings 2-3 hours after a meal that clear.
Hang in there, many of my patients parents and nurses that work with me who have type 1 worry daily about their other kids, I understand and would do the same
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