My three-year-old son wet the bed for three day. My doctor did a sugar test, which was 209 mg/dl [11.6 mmol/L], then we when to the Emergency Room. There, they drew blood and all tests were normal, even his A1c. They feed him a little bowl of macaroni and cheese. An hour later, his blood sugar was 310 mg/dl [17.2 mmol/L] so we made an appointment with a diabetes specialist. When the specialist checked my son’s fasting blood sugar, it was 105 mg/dl [5.8 mmol/L]. They drew blood for more tests, but we do not yet have the results. What could be going on?

While I am not certain I completely follow you, I think the summary is this: three-year-old with new onset bed wetting; glucoses checked and found to be elevated; but, SERUM glucoses in the Emergency Department and in the Pediatric Endocrinology office are normal. So, it looks like your child probably does not have diabetes!

Home glucose monitors are not accurate enough to MAKE a diagnosis of diabetes. They are allowed to be off by near 20%. If you HAVE diabetes, and your glucose reading is 150 mg/dl [8.5 mmol/L] (but with 20% error it could be 120 to 180 mg/dl [6.7 to 10.0 mmol/L]),that is a reasonable glucose. But given the definition of diabetes, including a confirmed fasting glucose from a serum test (not a “fingerstick”) being greater than 125 mg/dl [7.0 mmol/L], you don’t want to have too large an error: on a meter, a reading of “125 mg/dl [7.0 mmol/L]” might really mean the glucose is NORMAL at 100 mg/dl [5.6 mmol/L].

A fasting serum glucose of 105 mg/dl is a little high – a bit NOT consistent with diabetes – but does fulfill a consideration of “Impaired Fasting Glucose” which some consider a “pre-diabetes” picture.

I am glad you are working with a pediatric endocrinology and diabetes specialist. Ask them if they drew “pancreatic antibodies” or if they plan on having your child undergo a formal oral glucose tolerance test (OGTT). OGTTs are very specific with delineated directions in what to eat in the three days before the test and what amount of glucose to get at the start of the test. So, if this is to be done, it should be done under the direction of the pediatric diabetes specialists and not by “the laboratory” or the primary care doctor and maybe not even by an adult endocrinologist.

DS