Stephen J. Schueler, M.D.

Childhood Diabetes Evaluation

The evaluation of type 1 diabetes begins with a history and physical exam, including an eye exam.

Physical findings in someone with type 1 diabetes may include:

Tests are necessary to make the diagnosis of type 1 diabetes.

Tests that may be used to evaluate type 1 diabetes include:

Childhood Diabetes Fasting Blood Sugar

A fasting blood sugar can be useful to evaluate the control of type 1 diabetes.

A fasting blood glucose level measures the concentration of glucose in the bloodstream of someone who has not eaten for 8 hours.

In someone with untreated diabetes, the fasting blood glucose level is usually over 140 mg/dl. The diagnosis of diabetes is confirmed by two or more fasting glucose measurements over 140 mg/dl.

Childhood Diabetes Glucose Tolerance Test

A glucose tolerance test for type 1 diabetes includes:

  • A baseline, fasting blood glucose level is measured.
  • The person is given a dose of sugar by mouth.
  • The blood glucose level is measured every hour, for 4-5 hours after the dose of sugar.

Childhood Diabetes Hemoglobin A1c

The hemoglobin A1C test is an important test to evaluate how effectively a person is controlling type 1 diabetes. In poorly controlled diabetes the hemoglobin A1C is often over 8%. In well-controlled diabetes it is less than 7%.

Hemoglobin is the protein in your bloodstream that carries oxygen. In the setting of elevated blood glucose levels, hemoglobin binds to glucose. The hemoglobin A1C (glycosylated hemoglobin) blood test measures the amount of hemoglobin that is bound to glucose.

The hemoglobin A1C test determines how well the blood glucose level has been regulated over time. An elevated hemoglobin A1C measurement correlates with poorly controlled diabetes. This test can help monitor a person's response to treatment for diabetes.

Hemoglobin A1C may be performed any time of the day.

Normal Hemoglobin A1C: 4% to 5.9%

Childhood Diabetes Random Blood Sugar

In type 1 diabetes, it is normal for glucose levels go up and down slightly throughout the day. Even in someone without diabetes, the blood sugar may rise after a meal (120 to 140 mg/dl) and then return to normal (70 to 100 mg/dl) in a few hours. In diabetics, blood sugar levels usually remain above 160 mg/dl.

In diabetics, the blood sugar level is measured at certain times of the day: before meals, after meals, at bedtime, or after a dose of insulin. A random blood glucose level is a measurement of blood glucose that is performed any time, without regard to meal times, insulin doses, or time of day.

Continue to Childhood Diabetes Treatment

Last Updated: Jan 6, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Childhood Diabetes References
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  2. Larsson K, Elding-Larsson H, Cederwall E, Kockum K, Neiderud J, Sjoblad S, Lindberg B, Lernmark B, Cilio C, Ivarsson SA, Lernmark A. Genetic and perinatal factors as risk for childhood type 1 diabetes. Diabetes Metab Res Rev. 2004 Nov-Dec;20(6):429-37. [15386804]
  3. Mannucci E, Rotella F, Ricca V, Moretti S, Placidi GF, Rotella CM. Eating disorders in patients with type 1 diabetes: a meta-analysis. J Endocrinol Invest. 2005 May;28(5):417-9. [16075924]
  4. Schlosser M, Strebelow M, Rjasanowski I, Kerner W, Wassmuth R, Ziegler M. Prevalence of diabetes-associated autoantibodies in schoolchildren: the Karlsburg Type 1 Diabetes Risk Study. Ann N Y Acad Sci. 2004 Dec;1037:114-7. [15699502]
  5. Steck AK, Bugawan TL, Valdes AM, Emery LM, Blair A, Norris JM, Redondo MJ, Babu SR, Erlich HA, Eisenbarth GS, Rewers MJ. Association of non-HLA genes with type 1 diabetes autoimmunity. Diabetes. 2005 Aug;54(8):2482-6. [16046318]
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