Diagnosis

There are several blood tests for type 1 diabetes in children:

  • Random blood sugar test. This is the primary screening test for type 1 diabetes. A blood sample is taken at a random time. Regardless of when your child last ate, a random blood sugar level of 200 milligrams per deciliter (mg/dL), or 11.1 millimoles per liter (mmol/L), or higher suggests diabetes.
  • Glycated hemoglobin (A1C) test. This test indicates your child's average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). An A1C level of 6.5 percent or higher on two separate tests indicates diabetes.
  • Fasting blood sugar test. A blood sample is taken after your child fasts overnight. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 1 diabetes.

Additional tests

Your doctor will likely recommend additional tests to confirm the type of diabetes that your child has. It's important to distinguish between type 1 diabetes and type 2 diabetes because treatment strategies differ.

These additional tests include:

  • Blood tests to check for antibodies that are common in type 1 diabetes
  • Urine tests to check for the presence of ketones, which also suggests type 1 diabetes rather than type 2

After the diagnosis

Your child will need regular follow-up appointments to ensure good diabetes management and to check his or her A1C levels. The American Diabetes Association recommends an A1C of 7.5 or lower for all children.

Your doctor also will periodically use blood and urine tests to check your child's:

  • Cholesterol levels
  • Thyroid function
  • Kidney function

In addition, your doctor will regularly:

  • Assess your child's blood pressure and growth
  • Check the sites where your child tests blood sugar and delivers insulin

Your child will need regular eye examinations. Your child also might be screened for celiac disease at the time of diagnosis of diabetes and at intervals afterward, depending on your child's age and symptoms.

March 15, 2017
References
  1. Levitsky LL, et al. Epidemiology, presentation and diagnosis of type 1 diabetes mellitus in children and adolescents. http://www.uptodate.com/home. Accessed Nov. 4, 2016.
  2. Kliegman RM, et al. Diabetes mellitus in children. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Nov. 5, 2016.
  3. AskMayoExpert. Type 1 diabetes mellitus. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  4. Levitsky LL, et al. Management of type 1 diabetes mellitus in children and adolescents. http://www.uptodate.com/home. Accessed Nov. 4, 2016.
  5. Goldman L, et al., eds. Diabetes mellitus. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Nov. 5, 2016.
  6. Cameron FJ, et al. Care of diabetes in children and adolescents: Controversies, changes, and consensus. The Lancet. 2015;385:2096.
  7. Jameson L, et al., eds. Management of diabetes in children. In: Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Nov.5, 2016.
  8. Rewers M, et al. Environmental risk factors for type 1 diabetes. The Lancet. 2016;387:2340.
  9. Levitsky LL, et al. Complications and screening in children and adolescents with type 1 diabetes mellitus. http://www.uptodate.com/home. Accessed Nov. 4, 2016.
  10. Chiang JL, et al. Type 1 diabetes through the life span: A position statement of the American Diabetes Association. Diabetes Care. 2014;37:2034.
  11. Levitsky LL, et al. Special situations in children and adolescents with type 1 diabetes mellitus. http://www.uptodate.com/home. Accessed Nov. 4, 2016.
  12. Tools for effective diabetes management. National Institute of Diabetes and Digestive and Kidney Diseases. www.niddk.nih.gov/health-information/health-communication-programs/ndep/health-care-professionals/school-guide/Pages/publicationdetail.aspx. Accessed Nov. 5, 2016.
  13. Hyperglycemia (high blood glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html. Accessed Nov. 5, 2016.
  14. DKA (ketoacidosis) & ketones. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html. Accessed Nov. 5, 2016.
  15. School responsibilities under federal laws. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/health-communication-programs/ndep/health-care-professionals/school-guide/section4/Pages/default.aspx. Accessed Nov. 5, 2016.
  16. Buchberger B, et al. Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis. Psychoneuroendocrinology. 2016;70:70.