My two and a half year old son drinks excessively and urinates frequently during the day, and recently my mother-in-law was diagnosed with type 2 diabetes and brother-in-law was diagnosed with type 1 diabetes. I checked a random blood sugar today while he was drinking a milkshake which was 154 mg/dl [8.6 mmol/L], and, an hour and half later, it was 124 mg/dl [6.9 mmol/L]. Is this any reason for concern?

I would just keep watching for more symptoms. Due to your son’s age, antibody levels, if tested, they may not show up this early. If the thirst or frequent urination escalates, then I would go for a work up.

SH
Additional comments from Dr. Larry Deeb:

I have actually been quite surprised with “random” glucoses in people. Seems they do sometimes go higher than we write about. I, too, see the occasional glucose in a brother or sister that seems high and then several months of normals.

What to do? I actually have families check urine glucose, much less trauma and if it turns positive, then more evaluation. If the child is the right age for participation in the DPT-1 study, this might also be a choice.

LD

[Editor’s comment: While I would not be too alarmed, these blood sugars are a little high for child this age. In light of your son’s symptoms and family history, it certainly wouldn’t hurt to have his pediatrician evaluate him, if nothing else than to allay any concerns.

SS]

[Editor’s comment: Testing for diabetes should include blood sugar levels performed by a medical laboratory. The timing of the sample (fasting, random, or postprandial) would influence how high a level is considered abnormal. See Classification and Diagnosis of Diabetes for further information.

Occasionally, lab blood sugar testing might be normal in an early case of diabetes, repeat blood sugar testing at the same or a different time, or performing a glucose tolerance test, might be appropriate if there is a high suspicion of diabetes despite normal initial testing. Another test, the glycosylated hemoglobin, might be used to help confirm a suspected diagnosis of diabetes, but the GHB (also called HbA1c or A1c) is not usually considered as appropriate to make an initial diagnosis. Antibody testing is occasionally done as a screening test in high-risk situations, or as confirmatory of type 1A (autoimmune) diabetes, but is not part of routine testing. It would indeed be part of the testing for the DPT-1 study, as Dr. Deeb proposes.

Urine sugar tests or home glucose testing, if done, might be positive, which would make the situation more urgent to get lab testing done to confirm the abnormal results. However, urine or home glucose testing, if negative, would not exclude diabetes.

WWQ]