About two months ago, my two and a half year old daughter had a urinalysis which showed 3+ glucose and 1+ ketones. A blood sugar taken at that time (8:00pm), was 97 mg/dl [5.4 mmol/L], and two days later, she had a fasting blood sugar of 50 mg/dl [2.8 mmol/L], a hemoglobin A1c of 4.7%, and her urine was clear. One month repeat labs (which pediatrician wanted) showed a fasting blood sugar of 87 mg/dl [4.8 mmol/L], and her urine is clear.

My family has a very strong history of diabetes, and my mom thinks we need to keep investigating as my daughter may be developing diabetes, but her pediatrician is not acting concerned. Where should I go from here?

I hope you find my answer reassuring. Your daughter does not have diabetes! Just as “not all that glitters is gold”, not all that has glucose in urine (or elevations in blood glucose) is diabetes. I don’t think you need to do anything!

As for your strong family history, at this point we do not have a definite way to prevent diabetes in those at high risk, but you can reduce the risk factors. Avoid obesity! Keep her active! Watch for symptoms (increase in urination, increase in thirst). Don’t hesitate to have her rechecked if symptoms occur, but I would not advocate any further testing at this time.

DS

[Editor’s comment: In a scenario like this, it would make sense to remind any physician caring for your daughter to recheck her blood sugar level at the time of any future illness where blood needs to be drawn for any other testing.

WWQ]