My husband was diagnosed with type 1 diabetes at the age of six months. Recently, my two and a half-year-old son has started displaying symptoms of diabetes (frequent urination, excessive thirst) and has had several random blood sugars over 300 mg/dl [16.7 mmol/L] and a couple of fasting blood sugars over 250 mg/dl [13.9 mmol/L]. His A1c was 4.8%. We have consulted a pediatric endocrinologist and are waiting for blood work results. In addition, my four and a half-year-old son is having random sugars over 300 mg/dl [16.7 mmol/L]. Neither is showing ketones in their urine. We have checked the meters and they are correct. What are the odds of both boys being diabetic? Could it be MODY?

Such high blood glucose levels are extremely abnormal. You are correct to consult for both children. Early phases of disables can have just random hyperglycemia that then comes down since the “dying” pancreas makes some insulin some of the time. I would certainly encourage more consistent monitoring to know what you are dealing with and how often there are such spikes occurring. MODY testing would also be important not only for your husband but perhaps then also for these young children if your husband were positive. Other antibody testing would also be helpful to decide what type of diabetes this may be or may become. Certainly with any intercurrent illness, even mild respiratory or gastrointestinal illness, you want to keep close tabs on blood sugar levels to be sure that decompensation does not occur with such added “stress.”

Actual risks of a father then having a child with diabetes are in the neighborhood of 3 to 6%; two children, less.

SB