June 22, 2006
A1c (Glycohemoglobin, HgbA1c), Diagnosis and Symptoms
Question from Livonia, Michigan, USA:
I have access to a glucometer that I believe is accurate. My son told me he wasn’t feeling well a few hours after we ate yesterday and his blood sugar was 187 mg/dl [10.4 mmol/L]. I checked his fasting blood sugar this morning and it was 169 mg/dl [9.4 mmol/L]. I called the pediatrician and took him in. They checked his blood sugar in the office two hours later, still fasting, and it was 80 mg/dl [4.4 mmol/L]. They assumed my reading was incorrect, but they drew an A1c and will have the results Monday. They also suggested that maybe I just am catching it really early. An hour after lunch, on our home machine (that I have compared to other machines), it was 249 mg/dl [13.8 mmol/L]. Assuming our machine is correct, can an otherwise normal child, without diabetes, have sugars at those levels? Also, how do I account for the normal blood sugar two hours after the abnormal one, assuming again that both were accurate? Or, is there no way they could both have been accurate? If I were just catching it really early, would the A1c still be elevated? The only medications he is on is Zantac for reflux and some amoxicillin for an ear infection.
Answer:
A normal blood sugar for a non-diabetic ranges between 65 and 110 mg/dl [3.6 and 6.1 mmol/L]. It is common to have blood sugars higher than this if the blood sugar is read after a meal. Your pediatrician should be able to help you sort this out. Most, if not all, children that are diagnosed with type 1 diabetes have symptoms of diabetes at the time of diagnosis, including weight loss, excessive hunger, excessive thirst and/or frequent urination. Using a hand held glucometer at home is not a good way to reliably make a diagnosis of diabetes, especially when there is some doubt about whether the meter may not be functioning properly. Your best resource is your pediatrician who can order tests and follow your child for any symptoms of diabetes.
MSB
