My six-year-old’s fasting blood sugar was 6.1 mmol/L [110 mg/dl]. We were told that it was slightly over the normal range of 3.6 to 6.0 mmol/L [65 to 109 mg/dl]. We are very concerned about it and have asked the doctor to repeat the test so she has arranged an OGTT for him. Should we be concerned about this? Is it normal for children to have a slightly elevated blood sugar? Can it lead to either type 1 or type 2? If the OGTT shows his blood sugar is 5.8 or 5.9 mmol/L [105 or 107 mg/dl], is that still considered high for a child? My son does drink a little more than usual and sometimes wets his bed at night. During the day, he does not urinate frequently.

His maternal grandmother had diabetes and passed away due to kidney complications. She was diagnosed later in her life and had a very high blood sugar. She was very thin and had thyroid (goiter) as well. I am not sure if she had type 1 or type 2.

About 2.5% of “normal” children will have such high values on any test. I don’t think that you need a formal OGTT as this is almost always now done for research purposes in children. However, some home blood glucose monitoring would be more appropriate since this would tell you what his blood glucose values are with regular eating and snacking. We usually do such tests before and one to two hours after meals for several days and then review these results. If there were still some question, then antibody testing (islet cell, GAD65 and insulin antibodies) would be available for analysis to see if there were islet inflammatory changes present. With your family history, it was more likely this was late onset type 1 diabetes, especially if there were concomitant Hashimoto’s thyroiditis as the cause of the thyroid problems in this relative; it is difficult to know at this point, probably. If the blood glucose testing either by home monitoring or OGTT were still borderline, then consultation with a pediatric diabetologist would be prudent.

SB