My seven year old son’s father has had type 1 diabetes since he was sixteen, and two years ago, my son started showing signs of diabetes. His blood sugars ran anywhere from 70-220 mg/dl [3.9-12.2 mmol/L] for several weeks and then they went back to normal. Since then, he has had episodes of high blood sugar, but it always goes back to normal without intervention. He saw an endocrinologist who said that his pancreas could be “sputtering” and that he will eventually develop diabetes. Do you agree or do you think that it could be something else?

I think I have seen “sputtering” pancreatic function, too. This question could be more strongly addressed by one or both of the following:

Get pancreatic antibody testing for evidence of the typical autoimmunity that causes most cases of type�1 diabetes. These blood tests measure the GAD 65, ICA 512, and insulin autoantibodies. (The ICA 512 antibodies are also called the tyrosine kinase and the IA 2 antibodies).
Perform a properly done, properly prepped glucose tolerance test. Ideally, the patient will consume at least 60% of all the calories over the three days prior to the test as carbohydrates. The night before the test, the patient should have nothing to eat or drink (except water) until the test the next day. The oral glucose load is quite specific as a dose of 1.75 grams per kilogram body weight to maximum of 75 grams. Glucose and insulin should be measured during the testing. (I do not usually advocate for oral glucose tolerance tests, but your child’s situation may be one of those times.

If the antibodies are positive, it suggests risk of type 1 diabetes. The OGTT will indicate the presence of diabetes now (type 1 or 2) or risk of glucose intolerance (prediabetes).

DS