This isn’t so bad, but I’m feeling morose. Joslin called. It was our TrialNet doctor. He said something like, you remember Jack had an abnormal result, and as you know, we had him repeat the test, and that result was also abnormal, and in fact the results both times were high enough (253, 256) to meet the ADA criteria for diagnosis with Type 1 diabetes.
That part was not a surprise. This part was more new:
This is different from your diagnosis, in that things usually happen much faster with kids, I mean it’s not an emergency, but I recommend you get him in to see a pediatric endocrinologist, definitely within, say, the next few weeks. Do you have someone you could see?
Our endo is moving away at the end of June. (Wahhhh.) So maybe Jack can slide in to see her once before she leaves. Even though he’ll be immediately passed along to a new endo, I’m hoping Dream Endo will give him a dazzling, witty introduction to T1d, and tell him some concrete thing like maybe…
- Get a Dexcom and watch how what you eat affects your blood glucose, then avoid foods that give you highs or rebound lows.
- Test your fasting BG a few times a week and then call for an insulin prescription when it’s over 120 mg/dL more often than not.
- Take insulin starting now to preserve beta cell function. Here is a syringe. Here is an orange.
- Since you’re in the middle of the growth spurt, your blood sugar is higher than usual. Take this insulin for a week, and then your diabetes will go away until after college or maybe forever.
But I think it is more likely the suggestion will be something like…
- Just eat/do what you enjoy. You’ll have to deal with it all soon enough, and there is no proof that you can delay things anyway.
- What are you even doing here, in my office? You are fine. Go home.
Whatever the suggestion is, I’ll take it. I just don’t want the suggestion to be follow your gut. There is no gut. My gut is done, dried up like the gut of a roadkill squirrel.
One bright spot: now that Jack’s diagnosed, the big secret can be revealed. Drug or placebo? We’d all bet on drug, since he had the weird side effects of teplizumab, including the skin peeling off of the palms of his hands, and also there was the (not small) matter of a return to normal blood glucose during OGTTs for over two years. But maybe there will be other secrets revealed; maybe his A1c’s or c-peptides will be interesting, or we will find out we’ve won six million dollars.
The morose part: It was fun to be in a research study when my child was getting a special thing that not everyone could have and he was super-lucky. Now we’re just bleh, bruised banana, grumblelumps with no secret passageways or fancy shortcuts in sight.