Question from Grand Forks, North Dakota, USA:

Because of occasional high blood sugars, we have been monitoring our daughter’s blood sugars since January 2005 to see if she is developing type 1 diabetes. Things are still in question regarding what is going on.

We did not check her sugar much this summer. In June, she didn’t look well one day, having dark eye circles, but, she had a busy day and acted fine. We got home and she took a four hour nap, which is unusual. We checked her blood sugar, five hours after her last food, and it was 130 mg/dl [7.2 mmol/L]. The next morning it was fine, 75 mg/dl [4.2 mmol/L]. I called the pediatrician’s office and they said they didn’t think it was so unusual since she had a busy day.

Then, at the end of July, for a week straight, she was really crabby in the morning. When I picked her up from daycare, she was crabby, hungry and tired. I just thought she was maybe having a growth spurt. In the middle of that week I checked her one hour after supper and it was 197 mg/dl [10.9 mmol/L]. Another hour later, she was 111 mg/dl [6.2 mmol/L]. If she’s ever high at an hour, she’s always back down after two hours. Then, she was 75 mg/dl [4.2 mmol/L] the next morning.

We mentioned this to the pediatrician at her four year check up. He said he thinks she maybe glucose intolerant or resistant (I can’t remember which) and doesn’t know what he would do if she were intolerant/resistant if she had an abnormal Oral Glucose Tolerance Test (OGTT). At this time, she has no bladder issues. I only checked her sugar those few times this summer when we were in question.

In your opinion, should we do the OGTT on a four year old? Or, should we just wait to see what time tells? Or, should we just go to see a pediatric endocrinologist?