Celiac testing often includes looking at total IgA levels, because if someone is deficient the IgA tests for celiac disease may not be accurate (false negatives).  Did her doctors say anything about how much gluten she should consume?  If you change that it could affect her next test results.

@mytype1diabetes, Do keep in mind that Celiac Disease is genetic, so all first degree relatives (parents, siblings) should be checked for celiac disease as well.   Thiamine deficiency is common in breastfeeding mothers and their babies, even in countries where people are well fed and eat healthy.  A high carbohydrate diet requires more thiamine to turn those calories into energy.  Mothers on a high carbohydrate diet can be deficient in thiamine which also causes the infant to be deficient. DKA is found in children with thiamine deficiency.   Thiamine deficiency correction is part of DKA treatment. Thiamine deficiency needs to be addressed and corrected quickly and maintained.  Ask for an Erythrocyte Transketolace test for thiamine deficiency. I've experienced this myself.  Diabetics continue to lose thiamine due to poor renal uptake. Thiamine should be supplemented daily.  Thiamine is a constant in my life which helps immensely with my diabetes.   References: Thiamine deficiency in pregnancy and lactation: implications and present perspectives https://pmc.ncbi.nlm.nih.gov/articles/PMC10158844/ Pediatric thiamine deficiency disorders in high‐income countries between 2000 and 2020: a clinical reappraisal https://pmc.ncbi.nlm.nih.gov/articles/PMC9290709/ Hiding in Plain Sight: Modern Thiamine Deficiency https://pmc.ncbi.nlm.nih.gov/articles/PMC8533683/ The Impact of Thiamine Treatment in the Diabetes Mellitus   https://pmc.ncbi.nlm.nih.gov/articles/PMC3376872/#:~:text=Low plasma thiamine level was,increase in thiamine transporter expression. Thiamine as adjunctive therapy for diabetic ketoacidosis (DKAT) trial protocol and statistical analysis plan: a prospective, single-centre, double-blind, randomised, placebo-controlled clinical trial in the USA https://pmc.ncbi.nlm.nih.gov/articles/PMC10910407/#:~:text=Introduction,acidemia in patients with DKA. The relationship between lactate and thiamine levels in patients with diabetic ketoacidosis https://pubmed.ncbi.nlm.nih.gov/23993771/ Acute thiamine deficiency in diabetic ketoacidosis: Diagnosis and management https://pubmed.ncbi.nlm.nih.gov/17006386/ Thiamine status during treatment of diabetic ketoacidosis in children - tertiary care centre experience https://pubmed.ncbi.nlm.nih.gov/36440592/ Low thiamine levels in children with type 1 diabetes and diabetic ketoacidosis: a pilot study https://pubmed.ncbi.nlm.nih.gov/25560422/

Thanks for this Wends and appreciate your insights! I'm not sure what you mean by "Your toddler is unlikely igA deficient with a titer of 22, as a positive test." ? I had a look at Dr Bernstein's work and we've definitely noticed that on lower carb days her blood glucose levels are much easier to manage. Our nutritionist advised against a low carb diet for toddlers as they said young children, unlike adults, rely on carbs for their growth and development. What's your view on this? Regarding malabsorption - it's so hard to know what's "normal". My daughter's poos have always been on the softer side as she's breastfed and we eat very healthily. I've booked an appointment with our GP and will take some photos!

Thank you all for your kind wishes, it means so much. The information you've all shared has been so useful. We have a great diabetes team and trust the consultants decision to wait a few months to repeat the blood test. We also don't want to put her through any more tests than she needs as it's so tough on her and us! It feels unbearable waiting when she has some unexplained symptoms and as her mum I want to make sure we're doing everything we can to keep her healthy. That's interesting re: iron levels. I hadn't thought about that but I'm pretty sure this would've been checked as she was in hospital with DKA and they did lots of tests. I have requested a copy of her results.

It seems crazy to me that even when you call a manufacturer they can't, in this day and age, answer the simple question about what exactly is in their product!!