From Centralia, Illinois, USA:
My six year old son was diagnosed with ADHD at the age of four. Last week, his psychologist ordered some laboratory work to check his liver function to make sure he was tolerating the medicine well. She ordered a CMP (Comprehensive Metabolic Panel) and a TSH. His blood sugar level was 44 mg/dl [2.4 mmol/L]. I am an RN so I watched him and gave him something to eat. He ate a chocolate candy bar and a hot dog. I rechecked his blood sugar with a home glucometer (which was calibrated) four or five hours later and his blood sugar was 198 mg/dl [11.0 mmol/L]. Since this happened on a weekend when no doctors' office were open, I just monitored him until Monday. His blood sugars ranged from 80 to 188 mg/dl [4.4 to 10.4 mmol/L].
When I took him to the doctor, she was concerned about the low blood sugar reading but not the high ones. She said I need to monitor his diet better and give him frequent meals. He takes medication that suppresses his appetite and does not eat junk food all the time, which I explained to her. She instructed me to monitor his levels for one week and see her again with a log book. His blood sugars, after two days, continued to fluctuate from 93 to 188 mg/dl [5.2 to 10.4 mmol/L] throughout the day. I do not understand why she would not be concerned.
I had taken him to the doctor two weeks prior to this incident because he was having increased thirst and frequent urination. They checked his urine and it was okay, but did not check his blood sugar nor did they check it when I took him to the laboratory for the other blood tests. I am concerned about my child and I need some help. I asked the doctor about an OGTT or a A1c and she said those tests are not needed at this time because she is not concerned about the higher readings. Should I push for further tests or to see a pediatric endocrinologist?
You may wish to get a two hour OGTT to test for diabetes, since your son has clearly had some blood sugars that seem too high. The low blood sugars can be equally concerning and your pediatrician should be a good resource in determining the proper treatment and cause of those low blood sugars. A hemoglobin A1c is not a good screening test for diabetes. If your physician doesn't meet your needs, you may wish to visit with another pediatrician or a pediatric endocrinologist.
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