I have a 10-year-old with type 1. Recently, my 12-year-old daughter has been very tired lately, although, unlike my son, she hasn’t been drinking a lot or eating a lot. I’ve tested her blood a few times and she ranged from 78 to 200 mg/dl [4.3 to 11.1 mmol/L]. I scheduled a doctors appointment mostly because of her weight and lethargy. They didn’t test her blood sugar level the time I took her, but they wanted to see us the following week because he agreed her low weight was somewhat alarming. When my husband went to that appointment, they pretty much said she gained a pound and it’s most likely just hormones…that’s all we got. When I schedule doctors’ appointments for my daughter, she is usually doing better by the time we actually go. Is having a blood sugar of 200 mg/dl [11.1 mmol/L], twice yesterday, normal for a non-diabetic? She also has trace ketones. Am I overreacting to want to take her to the Emergency Room? She’s been so tired and just isn’t herself.

Blood sugars in people without diabetes are NEVER 200 mg/dl [11.1 mol/L] unless there is a problem with out-of-date test strips, weak batteries, non-clean fingertips or some other technique problem. Ketones just indicate the body is burning fat, so they can happen from insulin deficiency and high sugars (DKA) but also from any illness where there is insufficient calories, just insufficient food for any reason, etc.

I would suggest that you discuss this with your diabetes team immediately since, as specialists, they know you and the family, family history, etc. They will likely want to see you for a formal consultation, do other tests like A1c, insulin levels, antibody levels, etc.

I also would suggest that you keep watching weight, urine or blood ketones and keep monitoring the blood glucose levels before and after food so that if this really were the beginning stage of diabetes, then she wouldn’t get sick or dehydrated and you would know if the values are more than intermittently high. Testing her for pancreas antibodies would be reasonable to see if this is early diabetes. Also, make sure that there are not other explanations or diagnoses to consider. I agree that this is not normal and agree that this should be checked out more thoroughly than what you describe.

SB