Now 11, my son is almost 5 feet tall and weighs only 61 pounds. To some extent, we have been through the ringer for the last two years. He has had blood sugars that range between 100 and 200 mg/dl [5.5 and 11.1 mmol/L] while his A1c has gone between 4 and 5. He exhibits all the signs and symptoms yet his blood work results are never conclusive. We have taken him to a pediatric endocrinologist. They tested him for so much it required 11 tubes of blood. He almost passed out. We have done the oral glucose test and it is always at the high end of normal. Everyone in my dad’s family has diabetes and thyroid disease. My son also has a goiter on his thyroid which has never been treated. Today, after a normal day of eating and snacking and swimming he said he needed his sugar tested; it was 137 mg/dl [7.6 mmol/L]. This test was randomly timed and out of the blue for him to ask. He was shaking visibly and a little short of breath. He does have some odd behavior issues that I sometimes feel is his blood sugar being elevated. So, what now? I sometimes think my PCP thinks I am crazy, but is this normal?

None of what you describe is normal but without seeing the exact tests that were done by your pediatric endocrinologist, it is difficult to say for sure what the issue is. You may want to get a second opinion but take the original results with you so that things won’t automatically need to be duplicated; sometimes comparisons are helpful. Certainly, the random high glucose levels are not normal and so this is at least a prediabetes or a glucose intolerance situation. Antibody levels would be interesting to be checked. If negative, they won’t be helpful but, if positive, then follow up testing would be different. Unless he also has some hypoglycemia, it is unlikely that he would have many symptoms, however. It is important to go back to your pediatric endocrinologist and discuss your concerns about behavior to see if this may or may not be related. Sometimes, doing more home blood glucose checks, especially when symptoms occur, would also answer such questions as to cause and effect. Sequential testing may also be helpful to see if things are changing or not.

His small goiter is a separate issue. Thyroid antibody levels would indicate Hashimoto’s thyroiditis as the cause, if positive. Thyroid functions would also be important to track several times a year to make sure that the function of the gland itself stays normal. If changing, then, hopefully, such changes would be detected before other symptoms.

SB