Is a random post‑prandial blood glucose of 7.1 mmol/L (≈128 mg/dL) normal in a 5‑year‑old child?

A random post-prandial blood glucose of 7.1 mmol/L (128 mg/dL) in a 5-year-old child is completely normal and requires no intervention.

Normal Pediatric Blood Glucose Ranges

This value falls well within the expected range for a healthy child after eating. 1

• The American Diabetes Association recommends that postprandial measurements taken 1–2 hours after meals should not exceed 140 mg/dL (7.8 mmol/L) in healthy children 1
• Your relative's value of 128 mg/dL (7.1 mmol/L) is below this threshold and represents a normal physiologic response to food intake 1
• For context, fasting glucose levels for healthy children range between 70–100 mg/dL (3.9–5.6 mmol/L), and post-meal values naturally rise above fasting levels 1

Why This Value Is Reassuring

The key distinction is between normal post-meal elevation and pathologic hyperglycemia. 2

• Random blood glucose values of 140–180 mg/dL (7.8–10.0 mmol/L) have high specificity (92–98%) for diabetes and warrant confirmatory testing, but your relative's value is well below this range 2
• Diabetes diagnosis in children requires either:
  • Random glucose ≥200 mg/dL (11.1 mmol/L) with classic symptoms (polyuria, polydipsia, weight loss), OR
  • Fasting glucose ≥126 mg/dL (7.0 mmol/L) on two separate occasions 2
• A single post-meal value of 128 mg/dL meets neither criterion 2

Critical Context: Stress Hyperglycemia vs. Diabetes

One important caveat: if this child has an acute illness, even higher values may not indicate diabetes. 2

• The American Diabetes Association explicitly notes that young children with acute illness may experience "stress hyperglycemia" that does not necessarily indicate new-onset diabetes 2
• If the child is currently sick, feverish, or under physiologic stress, glucose values can be transiently elevated without pathologic significance 2
• Consultation with a pediatric endocrinologist is indicated only if there are repeated elevated values, classic diabetes symptoms, or immunological/metabolic markers for diabetes 2

When to Worry: Red Flags That Are NOT Present Here

None of these concerning features apply to your relative's situation: 2, 1

• Random glucose ≥200 mg/dL with symptoms (polyuria, polydipsia, weight loss, fatigue) → Not present 2
• Random glucose 140–180 mg/dL requiring confirmatory testing → Not present 2
• Fasting glucose 100–125 mg/dL suggesting prediabetes → Not applicable (this was a post-meal value) 2, 1
• Glucose in urine (glucosuria occurs when blood glucose exceeds 180 mg/dL) → Not present 1

No Action Required

Reassure the family that this is a normal finding. 1

• No repeat testing is needed based on this single normal post-meal value 2
• No dietary changes or restrictions are indicated 1
• Routine well-child care and age-appropriate screening are sufficient 2

Measurement Accuracy Note

If there is any concern about the accuracy of the reading, consider the measurement method. 2

• Handheld glucose meters are frequently used but can have variability 2
• Blood gas analyzers with glucose modules provide the most accurate measurements in young children, superior to handheld meters 2
• However, given that this value is clearly normal regardless of minor measurement variability, confirmation with laboratory testing is unnecessary 2