My son was recently diagnosed with hyperactive insulin response, which gives him low blood sugar a few hours after a meal. I would like to monitor his blood sugar after he eats, etc., but I do not know what his target range for blood sugars would be. He is eight years old and weighs 53 pounds. The doctor also said this is sometimes a precursor to diabetes, but not always. We have a history of type 1 in our family. Is this the type he may be at risk to get? Can altering his diet now help prevent diabetes in the future?

These are great questions, but we do not know any of these answers, except that normal blood glucose levels before eating are generally in the 60 to 99 mg/dl [3.3 to 5.5 mmol/L] range. After eating, generally, below 130 mg/dl [7.2 mmol/L] is acceptable, while some people say below 140 mg/dl [7.8 mmol/L].

Our usual advice is to avoid fast acting carbohydrates, including sugar containing liquids, juices, soda, candy, fruits, and always have something to eat every three hours, something that contains some fat and protein since this would slow down the insulin releasing signal. Some people can have complex carbohydrates high in fiber while this has to be individualized for others. Stay in contact with your endocrinologist so that you can get individualized advice.

You are also correct that sometimes this is a precursor to developing diabetes, but usually not. About 90% of people, kids included, can be treated with wise meal and snack planning and this usually avoids recurrent episodes of such “reactive” hypoglycemia.

SB