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August 18, 2021

Diagnosis and Symptoms, Meal Planning, Food and Diet, Type 2 in Youth

Question from Georgia, USA:

I took my grandson for his two year check-up and asked them to check his blood sugar since his mom, my daughter, has had type 2 diabetes since she was seven years old. My grandson’s blood sugar was 148 mg/dl [8.2 mmol/L] so the doctor suggested we try to avoid feeding him sugary foods, which I have done. For peace of mind, I bought a meter and checked him at home. His blood sugar was 151 mg/dl [8.4 mmol/L]. He had eaten a cookie about an hour earlier. Is this something concerning? Is there something I can do to help lower his blood sugar?


From: Marissa Town, BSN, RN, CDCES

Diabetes is diagnosed when a fasting (not eating for 8 hours) blood glucose level is greater than 126 mg/dl [7 mmol/L] or a random glucose is over 200 mg/dl [11.1 mmol/L] and the person is having symptoms, per the International Society for Pediatric and Adolescent Diabetes Diagnosis Guidelines from 2018. If he had eaten recently, it’s hard to say if the glucose levels are an issue or not. You would need to wait a full two hours after a meal to see if it is less than 140 mg/dL [7.8 mmol/L].

Given the family history, keeping a close eye on him as you are doing is a great idea! As far as helping lower his blood glucose levels, the best way is lifestyle modifications, meaning eating healthy and being physically active. For kids aged 6 to 17, the Centers for Disease Control and Prevention (CDC), recommend 60 minutes of exercise daily minimum. You can find more information about that here: How much physical activity do children need? Everything that you can do to help increase his activity and movement will be helpful, so if 60 minutes a day starting out seems unrealistic, start more slowly with goals that will actually be achievable for him and your family.

For healthy eating, I would recommend reviewing MyPlate from the US Department of Agriculture. The typical recommendation is to fill half of your plate with non-starchy vegetables (salad, cucumber, green beans, etc.), one quarter of your plate with whole grain carbohydrates and one quarter with lean protein. Again, this can sound really challenging for a lot of folks, so start with one or two things at a time so that you don’t get overwhelmed! You can also use a lot of free tools such as My Fitness Pal, which has an app and a website, or Calorie King to help identify the nutrition contents of the food you are eating.

Everything is fine in moderation, and it can be more harmful than helpful to eliminate foods from kids’ diets. Many kids, if not allowed to consume any type of sugar, end up sneaking the food without their parents’ knowledge. It’s better to encourage smaller portions of desserts/high carbohydrate foods and increase the portions of non-starchy vegetables, whole grain carbohydrates, lean proteins, and fruits.

It is always helpful to have the whole family involved when getting healthier and be supportive of each other’s goals. We have an article about making SMART goals that is also really helpful: Ringing in a SMART New Year. It can also be very helpful to meet with a diabetes educator to get more information and get more hands-on teaching. Your daughter should qualify for seeing an educator if she has diabetes, and perhaps you could all go to learn together. It’s really great that you are trying to help and being a supportive parent and grandparent!