My son has had blood sugar readings in the 130s mg/dl [7.3 to 7.7 mmol/L] after eating and sometimes in the 150s mg/dl [8.3 to 8.8 mmol/L]. He was tested two years ago for the antibody, which came back negative. These spikes have been happening for several years. Does he have a greater chance of getting diabetes in his future because of these elevated readings? By cutting sugar intake, do I decrease his chances of diabetes? The endocrinologist said he is just active, but the pediatrician says he is high risk. What are your thoughts? I am very concerned and don’t know what to think.

This has nothing to do with being active. Such intermittent high glucose spikes suggest at least intermittent insulin insufficiency and you are correct that this places him at higher risk for developing full-fledged diabetes in the future. This would be particularly true if your child were obese or gaining weight excessively. If the antibodies were negative in the past, they also could change in the future and much is not known about the natural history of type 1 diabetes. While it is not so practical to avoid sugars completely, cutting back would be reasonable and do-able. It is most important that you pay attention (excess thirst, excess urination) during periods of rapid growth, or during illnesses (i.e., viruses) since those are times when extra insulin is often needed and so, diabetes may show up clinically. Checking blood glucose values at home during such stressful time periods would also be helpful.

SB