My daughter just turned seven. Both of my parents are suffering from diabetes and my father-in-law and all of his siblings have diabetes. Neither my husband nor I have diabetes. My daughter is heavyweight and is showing some of the symptoms of diabetes, thirst, urination, and extreme hunger. She sometimes eats too much sugar on a daily basis. Yesterday morning, I checked her fasting blood sugar and it was 103 mg/dl. I tested her blood yesterday morning in fasting and the reading was 103 mg/dl [5.7 mmol/L]. It shocked me because it was close to 110 mg/dl [6.1 mmol/L]. I did not give her any sweets yesterday, so I when I checked her blood sugar again this morning, I was even more shocked that it was 117 mg/dl [6.5 mmol/L]. I tested her again and the reading was 115 mg/dl [6.4 mmol/L]. What else might cause her blood sugar to be so high? She is not taking any medicine currently.

I am presuming that the members of your family who have diabetes mellitus, more accurately have “type 2” diabetes. This is the type that more typically occurs in adults, toward middle-age, and in those who are overweight and lead sedentary life styles. In type 2 diabetes, the affected individual usually is able to produce generous amounts of insulin but their bodies are relatively resistant to the effects of insulin. Type 1 diabetes, more often occurring in children, is associated with inadequate production of insulin and can lead to serious metabolic consequences and death if insulin is not provided by injection. Both type 1 and type 2 diabetes can have family trends and be inherited. There are other types of diabetes, also, but they are more rare or have no role in a seven-year-old on no medications.

You did not indicate how you measured your daughter’s glucose, but presumably it was from a hand-held glucose meter. While these meters are fairly accurate, they can give a result that is up to 20% WRONG from the true glucose reading. So, for example, if the child’s TRUE blood glucose were 100 mg/dl [5.6 mmol/L], the meter could give a reading anywhere from 80 to 120 mg/dl [4.4 to 6.7 mmol/L]. This degree of inaccuracy is typically not so important when a known diabetic is measuring and managing their diabetes, but it is too inaccurate to establish a diagnosis of diabetes. Some glucose meters require special calibration and “coding” with their test strips. Does your meter require this?

Having said that, you describe a heavy seven-year-old with worrisome symptoms that are suggestive of glucose irregularities. The fasting blood glucose values that you have obtained and shared with us are supportive of a potential issue in glucose regulation. Please see our web page on the Classification and Diagnosis of Diabetes and some of the many previous questions we have answered about the Diagnosis and Symptoms of diabetes. Based on your description, I would wonder if your daughter may have “impaired fasting glucose” or maybe even “impaired glucose tolerance” – both are along the spectrum of “pre-diabetes.”

I suggest that you contact your reliable pediatric healthcare provider in order to have your daughter undergo some easy, outpatient blood and urine testing done while she is fasting (water being allowed). Such tests would include serum glucose, electrolytes, maybe a HbA1c, and urinalysis. Depending on these results, a formal oral glucose tolerance test (OGTT) might be required. OGTT tests are often done incorrectly in children (see a previous question explaining how an OGTT should be done).

If this remains “pre-diabetes” at this time, then your doctor will likely discuss with you a proper dietary and exercise approach for your daughter to get things under better metabolic control and to help her lose some weight but without stunting her growth in height. A referral to a pediatric nutritionist familiar with glucose issues may be a good resource. If testing suggests that your daughter does have diabetes now, then additional testing may be required to help determine if this would be type 1 or type 2 (or other) and then an individual treatment plan for your child can be constructed by your doctor and the nutritionist.

Good luck and let us know what you learn.

DS