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June 18, 2021

Diagnosis and Symptoms

Question from Florida, USA:

When I took my seven-year-old for his yearly check-up, he had glucose in his urine, so the doctor checked his A1c, which was 5.6. That evening, I checked his blood sugar and it was 196 mg/dL [10.9 mmol/L]. Concerned, I checked him several days in a row, got readings between 98 and 140 mg/dL [5.4 and 7.8 mmol/L]. It’s hard to get him to cooperate. I also checked overnight, three to four hours after eating, and he was 135 mg/dl [7.5 mmol/L]. Should I be concerned? I am worried about that one reading being almost 200 mg/dl [11.1 mmol/L].


From: Marissa Town, BSN, RN, CDCES

Is your child having symptoms of high blood sugar, such as thirst, frequent urination, extreme hunger or weight loss?

If his blood glucose were 196 mg/dl [10.9 mmol/L] in the morning, this would be concerning. The American Diabetes Association guidelines indicate that it is probably diabetes if one’s fasting blood sugar is over 126 mg/dl [5.6 mmol/L] or random blood sugar is over 200 mg/dl [11.1 mmol/L] WITH symptoms. Please ensure that his finger is clean and dry when you are checking his blood sugar since residual food can cause an erroneous reading.

If he were to have symptoms, you should check his blood sugar first thing in the morning and one to two hours after meals for several days. If those readings were elevated (over 126 mg/dl [5.6 mmol/L] fasting or over 200 mg/dl [11.1 mmol/L] randomly), you should take him to the doctor as soon as possible. In the meantime, another thing to consider is antibody testing. You could ask your pediatrician if he/she would consider blood work to check for ICA, IAA, GAD-65, and ZnT8 antibodies. This type of testing is often done by an endocrinologist, but you are unlikely to get an appointment with one before a diagnosis.