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Crysdd

5.7 Fasting A1C in a 3 year old

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Crysdd

HI All! My name is Crys(sounds like Chris), and want to give a little back story on my son Levi.

 

He's 3 1/2 and has a fraternal twin brother Cooper. =) When he was 3 months old he had 1/4 of his intestines removed due to a condition called Meckel's Diverticulum-a pouch on his intestine that got stuck to his belly button and it obstructed food/blood to go through. We eneded up having emergency surgery to have it removed. Well that resulted in him having short gut syndrome. So he has chronic diarrhea because of that.

 

Well lately he has been going more frequently and is begging for something to drink. I'll give him an 8 oz cup of watered down juice, and then he ask for me, I give him another 8 oz of water, and then wants more right away. So this in turn is making him go to the bathroom more, and him getting up in the middle of the night.

 

Well we were at a sick visit a little over a month ago and I asked the Pediatrician what she thought it could be, well she said to ask the GI doc since we were going to see him at the beginning of October. She wasn't sure if it was due to the short gut or not.

 

So we had our appointment on October 1st and he wanted to check his A1C levels to make sure everything was okay, so we took them and got a phone call back to say they were high( I unfortunately don't have the number for that) and we needed to do a fasting draw in a couple weeks. 

 

So we had our fasting draw on Saturday the 25th, and got a call back from the GI doc saying that his tests were still high, and we needed to call the Pediatrician and get something set up with an Endocrinologist, it said it was 5.7,  from everything I read it seems borderline, and it's not full on diabetes but it's pre-diabetes, and from what I've been reading it's saying pre-diabetes is an onset for type 2.

 

He's 3 years old, and he's not overweight at all. So I'm just waiting on a phone call from the pedi to see what the next step is. Any advice would be greatly appreciated!!

 

Thanks,

 

Crys

 

 

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rubidoux

Well, first, he is so adorable!   :wub:

 

I don't think you're dealing with t2 here, most likely.  If he's got diabetes, it's probably t1 and "pre-diabetes" doesn't really apply.  I would think the next step would be to do a blood test to see if he's got the antibodies associated with t1.  

 

I sure hope it turns out to be nothing, though.  It sounds like he and you already have a lot to deal with.  Please let us know what the doc says/does.

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Ela

Hi Crys and welcome to the forum!

 

What a cutie pie your son is!  :)

 

I'm not familiar with the short gut syndrome but other than that hate to upset you, but it's more likely that he is Type 1.  5.7 IS on the border but it's possible that he just developed this and result is skewed somewhat.  Your doctor should do more tests though and hopefully it's nothing.

 

Good luck and hugs!

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dowling gram

Hi. I agree you have an adorable little boy.

 

What is your treatment for the short gut? Do you have nutrition supplements and does he eat several small meals instead of big ones. Short gut does not allow full nutrition from food so much of it is not absorbed by the body. Taking small amounts of food often allows the body to absorb more of the nutrients from his food. I would search out a specialist for short gut before an endo and get that problem straightened out. He is in no danger waiting a while to treat diabetes--if that's what it is-- when you don't know for sure that's what is causing his A1C reading. You might want to keep tabs on it though and have another A1C in a few months

 

I think his A1C has more to do with the short gut than diabetes and if you address that issue his A1C will drop. People here are saying he may be type 1 because most young people with diabetes are type 1 but with the short gut it may not be diabetes at all. You might want to keep tabs and cut down on the amount of carbohydrates he eats. Don't cut them out entirely but limit them

 

I'm no expert and that is why I suggest you find a doctor who is. It just makes more sense to me to explore how the short gut is effecting things before you do anything about that A1C

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rubidoux

I don't know, the antibody test is a quick yes or no answer.  It seems like it would make sense to do the easy test and rule out diabetes.  I don't know anything about short gut, but I would be surprised if malabsorption could cause blood sugar problems.  Of course, if checking into the short gut issue can be done faster than the antibody test, then I'd go for it.  But I disagree that it's safe to let the possible t1 sit on the back burner.  I believe the progression from a barely detectible blood sugar problem to full blown DKA is much quicker in kids than in adults and you don't want him to go into DKA.  If the doctor has seen him recently and is not uptight, then I don't think you should be overly concerned about it, Crys, bc if he was showing signs, the doctor would have been all over it.  But you might want to google it and familiarize yourself with the signs, or ask the doctor about it.  

 

Another reason to test for t1 early, and I'm not real sure about this either..., is that I believe that starting insulin early can prolong the islet cell functioning some.

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DeusXM

A1c tests in children are a bit unreliable as there seems to be a lot of confusion over what is a 'normal' A1c for children - there is a school of thought which suggests kids may have higher A1cs than adults without actually having anything wrong with them. 

 

The easiest way of checking for likely T1 is monitoring ketones in urine. High ketone levels in individuals eating normal diets are indicative of insufficient insulin levels, so a ketone check is logically a far quicker and cheaper way of collating evidence. Simply put, there's no way an untreated T1 can have trace or no ketones.

 

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Crysdd

Thank you all for your responses!

 

Well his GI doctor is the one that ordered the the lab tests and they are the ones that told me I needed to see an Endo, and was told that his short gut wouldn't be a causing factor because the sugar levels is in the blood. (sorry if this is worded wrong). He does not absorb everything-especially bile salts or vitamin B12. But treatment right now is we take a probiotic and we just started on Pectin(ya it's used to make Jello), it's been up and down for the past 3 years. 

 

Still waiting on the doc to call me back!! =( 

 

His test results were:

 

glucose was 122 and A1C was 5.7, this was his 2nd test, first test all I know was 5.7 I don't know his glucose number.

 

Thanks for your help! 

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rubidoux

Ya know, my gut is telling me this isn't diabetes.  I probably shouldn't say that, I don't want to give you false hope, but I just feel like it wouldn't come up this way.  You brought him in because was having symptoms (drinking a lot) but I just can't imagine that the blood sugar levels you're talking about could possibly cause someone to be thirsty.  I don't get noticeably thirsty until I'm in the 300's at least, probably the high 300's.  It could be different for a child, but I just can't imagine something under about 150 or 180 making him thirsty.  It seems, though, that his GI doc did think that the 5.7 a1c was significant?  

 

Anyway, I'm really pulling for you.  Hugs!

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