Diabetes can be slow or rapidly developing, even in children. I do not think there is any other cause than diabetes at this point.
Would suggest the parents look into low carb eating for the child to avoid the highs, along with plenty of protein and healthy fats to keep blood sugars stable.
Please have them look up Bernstein Diabetes University, and children, on Utube. This resource will teach them a lot and may guide them in how to approach this and what to look out for.
I would be finding me a second opinion. If his sugars are running over 200. He has juvenile diabetes.
Yes! There are several reasons blood sugar can drop even if you don't have diabetes. Tumors of the pancreas or adrenal glands can cause this. Exocrine pancreatic insufficiency (lack of digestive enzymes) can cause this. Certain nondiabetic specific medications(eg certain antibiotics) can cause this. Malnutrition can cause this. Picky eaters can suffer from this. These are just some of the reasons you can have low blood sugar.
My youngest son has the same problem your grandson does. I am Type 1 (age 14 diagnosis). My oldest son was diagnosed with Type 1 at age 9. When my oldest son was diagnosed, my youngest son then 5 years old took it upon himself to also pee on the Ketosticks. We were shocked to see large ketones. However, his sugars were normal, so we didn't worry too much. As time passed, we would do periodic ketone and sugar checks. Sometimes he had ketones and slightly elevated sugars and sometimes not. His A1C was always normal. He developed hypothyroidism when he was 9 years old. When he was around 13 years old he began having issues with low blood sugar. It seemed he would randomly have severe low blood sugar. We started to checked his sugars 2 hours after meals, but they were always good. Please keep in mind that even nondiabetics can have sugars over 200 if they eat food (especially sweets) then test their blood sugar 30 minutes after they eat. Also, kids have different target ranges than adults. So then we did the glucose tolerance test. The results were inconclusive. His blood sugar ran a bit higher than what was considered normal for the first half of the test, but by the end of the test his sugars were back in normal range. His pediatrician was ready to diagnose him, but I wasn't convinced. Neither was my endocrinologist who was following his case as well.
We decided to look at other possible causes, and after lots of blood tests and imaging to look for tumors and such, we decided to just change how he ate. He was at the top of the growth chart in height but at the bottom of the growth chart for weight. We switched him to eating several times a day instead of what he was doing - almost no breakfast, light lunch, a few snacks after school and dinner when I forced him to come downstairs. As long as he ate something about every 3-4 hours he avoided the severe lows. Mom and Dad breathed a sigh of relief. He is 20 years old now and still fights low blood sugar when he goes too long without eating. What he doesn't have is a diabetic diagnosis.
My advice would be to not stress too much over this especially if your grandson is a picky eater. See what the pediatrician thinks about letting your grandson be a grazer, and consult a pediatric nutritionist. Be proactive about preventing low blood sugar. Instead of concentrating all his calories at meal time, spread the calories out over the whole day. Always have a baggie of his favorite snack at hand for him to munch away on and a juice box to chase those scary lows away! I hope all goes well with his future testing. Best of luck to your family.
Just wondering was your grandson ever diagnosed with t1 diabetes? My son is 3 1/2 and has been experiencing the EXACT same thing since July 2017. He would wake up and be lethargic, crying/winey. And not want To eat or drink anything and then would get really sick and vomit multiple times. One time we decided to test his blood since my husband is t1 (diagnosed at age 12) and so is my father inlaw and sister inlaw. When we tested my son that first time it was at 56 and we immediately made him eat some candy and tried to get him to drink juice (he refused). His blood sugar cane up and he was fine. Those low episodes happened about once every week for about 3 months and his pediatrician told us to just make sure he eats more carbs before bed. So we did. At that time his A1c was checked and was at 5.2. The episodes eventually tapered off and only occurred every 3-5 weeks and we weren’t so worried until just recently approx March 2018. In March he ended up getting the flu and after that we noticed he was peeing ALOT and drinking a lot. He even began wetting the bed occasionally which he’s hasn’t done in over a year (he’s fully potty trained). We began testing his blood again then. His fasting bs was at 138 one morning (which is high) and then a few other times it’s been either low (under 65) or once again high (above 126 fasting for 12 hours). We also started testing him 2-3 hours after meals and he would be above 140 sometimes as high as 198 (that was the highest). Then this past week he woke up sick. We though he was just tired because he didn’t get to bed till 11 the night before (bedtime is 8:30) and so we brushed it off the next morning (8am) when he wasn’t acting quite right. Well then at 10 am he still wasn’t and he began vomiting so we tested him after cleaning him up and his sugar was at 61. We gave him 1 serving of gummy bears (15 g carbs) and waited 15 min then gave 1 more serving of gummy bears. And then tested him 2 hours later. When we tested him he was at 181. Isn’t that a bit high for waiting 2 hours and all he had was 30 grams of carbs?
I’m just so worried about him and feel like his pediatrician doesn’t care at all about our conserns.
But, I would still favor type-1b as most likely.
I am fighting both highs and hypos myself, after being stable on insulin for 38 years. I am to have a adrenal workup soon.