My grandson’s doctor says he has borderline type 2 and is on a no sugar low carbohydrate diet with exercise. His great grandparents both were type 2, as well as several of his great uncles and aunts. His grandfather and father are not diabetics. There is American Indian, but is back to his great-great-great grandmother. His sugar levels stay around 85 to 125 mg/dl [4.7 to 6.9 mmol/L] most of the time. Lately, it has been up to 150 mg/dl [8.3 mmol/L] one day and down to 40 mg/dl [2.2 mmol/L] the next. I am concerned he may not have diabetes and this diet is causing more problems. I have talked to his parents, but they feel the doctor is right.

I am not really sure I understand your question. But, you began by saying that your grandson has “borderline” diabetes. While that is not a real medical term, it usually infers that he does NOT actually have diabetes, but rather is at higher RISK. Terms that are sometimes used interchangeably include “glucose intolerant” or “pre-diabetic.”

You should review our page on Classification and Diagnosis of Diabetes.

Without having access to the complete clinical assessment, I’d hazard a guess that the child’s doctor is right. And, especially if the boy is mild- to-moderately overweight and not as active as he could be, then the approach I would suggest would be to eat sensibly, CUT OUT the simple, wasted sugars in carbonated soft drinks, juice, sports drinks, punch, Kool-Aid, etc, cut BACK on starchy, complex carbohydrates, and exercise more. Whether the specific diet used at home is the “correct” one is difficult to say.

Remember that home glucose meters are not completely precise: they are accurate within about 20 percent, typically. For someone not on medication, I would view a glucose reading of 40 mg/dl [2.2 mmol/L] on such a device with suspicion as not being accurate.

The family may wish to ask for a referral or consultation with a pediatric endocrinologist.

DS