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Question:

From Eureka, California, USA:

I have read on this web site that a normal A1c for non-diabetic children is really at 5.0, but the normal range is considered 4.5 to 5.5, according to Dr. Jim Lane. My eight year old son had an A1c of 5.4. His fasting blood glucose was 93 mg/dl [5.2 mmol/L]. His random blood glucose in the pediatrician's office was 170 mg/dl [9.4 mmol/L]. He has periods of increased thirst and urination, both day and night.

I have checked his blood sugar with a meter and found it 125 mg/dl [6.9 mmol/L] 30 minutes after a piece of pizza. I didn't check further. It was also 122 mg/dl [6.8 mmol/L] two hours after a normal lunch.

My grandparents, dad, brother, aunts and others in my family have type 2. My dad's doctor thinks these numbers may indicate very early type 1.

Answer:

A1c values may change depending upon the specific laboratory and system being used for analysis. But, they only represent average glucose values for the prior four to eight weeks or so.

What you are describing is not quite abnormal, but not quite diagnostic. The fasting blood sugar was fine, but the post meal values are slightly too high. This could be early diabetes. So, I would go back to the pediatrician and consider a consultation with a pediatric diabetes team. It would also be reasonable for you to get a more detailed idea of what the blood sugar levels are for several days without changing food or snacks. We call this a profile and can easily be done with one of many home blood glucose meters available: just before breakfast plus one to two hours after breakfast, just before lunch and one to two hours after lunch plus just before dinner and one to two hours after dinner. The ideal values should include pre-meal values less than 100 mg/dl [5.6 mmol/L] plus post-meal values less than 126 mg/dl [7.0 mmol/L]. If these are not totally normal, and certainly if there are suspicious symptoms even intermittently (excess thirst, excess urination, unexplained weight loss, enuresis or night time urination etc.), then further testing is needed and might also include antibody testing as well as others.

SB

DTQ-20060525073649
Original posting 4 Jun 2006
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:10:08
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