My 11-year-old was diagnosed with type 1 diabetes in October 2006 after almost dying. After some higher, but not scary high blood sugars, (130s mg/dl [7.2 to 7.7 mmol/L] six to eight hours post meal in the middle of the night) and a few different symptoms (bed wetting, hiding drinking water, behavior changes after meals, etc.), we had our middle daughter tested. Her A1c came back at 5.6, which made me very happy since she had an A1c in the summer of 2007 that was 6.0. I got the results for her C-Peptide on Monday and I am confused. The pediatrician said she does not know how to interpret the results and the endocrinologist has yet to call me back. Her results are: 0.7 with a laboratory normal range of 0.9 to 4.3; and 231 with a laboratory normal range of 297 to 1419. Her antibodies are negative but, as we all know, you do not have to have antibodies.

You have C-Peptide results that are low and high-normal A1c levels. This could be early stages of diabetes (some call it pre-diabetes) but there is no way to know without further testing. At home, this would involve doing what we call a profile: before and one to two hours post-meal blood sugars for several days. This will tell you what the glucose levels are running on an every day schedule. Other testing would likely be done by a pediatric diabetes expert since it is complex and often not black and white, so interpretation is needed. This would include three or four antibodies and sequential analysis of the home monitoring plus beta cell reserves. Family history would also be important to assess. It is unlikely most primary care providers would be able to do this well, so I would agree with your call to the diabetes folks. There are some research genetic studies that also would help assess risk as to whether or not this child has the same or different genes as your first child with known diabetes.

SB