My 4 year old was diagnosed at 21 months with type 1. My 22 month old is now having blood glucoses in the 60’s and urinating heavily. He seems unusually tired and is thirsty a lot. Is it normal for him to have blood glucoses in the low 60’s or could he be developing diabetes also? The lows are occurring at different times during the day.

It is very understandable that you should be anxious about diabetes in your younger child and indeed there is a slightly increased risk because of the older sibling. However, delayed first phase insulin release causing hypoglycemia has not been reported as an early sign of islet cell damage in this age group; but this may well be because it has not been looked for. So I do not think that the low, albeit still normal, blood sugars indicate diabetes. The best way to allay anxiety though, assuming that your older child has autoimmune diabetes, would be to talk to the doctor about getting an antibody test done. A number to call to get more information is 1-800-425-8361.

DOB
Additional comments from Dr. Stuart Brink:

It doesn’t sound like there are high sugar levels. Blood glucose values in the 60’s are very common, particularly in toddlers. However, you should check what we call a full profile for a few days to be sure: before and 1-2 hours after eating breakfast, lunch and dinner. This would give you excellent information about possible subtle or intermittent high blood glucose levels. Also, you should let your pediatrician know about these symptoms to make sure a urinalysis has been checked and there is no other reason for the symptoms.

A hemoglobin A1c could be checked to determine overall blood glucose levels for the previous 6-8 weeks and an islet cell as well as GAD antibody test could be done to see if there is early islet cell inflammation. The antibody tests are available free of charge through the national DPT-1 screening study; your child’s diabetes team can either do these tests or place you in contact with people who can run them for you to check out your other son.

SB