If she doesn’t eat at certain times, my seven-year-old daughter shakes terribly. There is a family history of diabetes in both families. I also had gestational diabetes while pregnant with her. I had to check my blood glucose levels every morning and during the day. What are the percentages that she will develop diabetes? I don’t want to bother the doctor unnecessarily.

It sounds like your daughter could be hypoglycemic, so you definitely need to see your child’s physician and perhaps also consult with a pediatric endocrinologist. I usually want some blood glucose levels checked prior to and one to two hours after food for several days to get a better sense of what baseline is. For sure, whenever the shakiness occurs, it would also be important to know if this really is hypoglycemia, i.e., less than 60 mg/dl [3.3 mmol/L] or not. Occasionally, diabetes presents first with hypoglycemia and then the demise of the pancreas’ insulin production. More often this type of hypoglycemia is unrelated and simple meal planning, that is, three meals and three snacks with food never more than three hours apart, coupled with avoiding simple sugary foods, solves the problem, There are some more rare causes of hypoglycemia, such as liver disease, glycogen storage disease and adrenal insufficiency but usually with other problems. Thus, the reason to get a formal evaluation by your own doctor or a consultant pediatric endocrinologist.

SB