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December 6, 2000

Diagnosis and Symptoms

Question from Florida City, Florida, USA:

My five year old son, who weighs 51 pounds, had some tests done to rule out diabetes. There is adult diabetes on both sides of the family. His glycohemoglobin was 6.1%. Is this normal or high? Then they ordered a glucose tolerance test, and the results were: Fasting – 89 mg/dl [4.9 mmol/L]; one-half-hour – 229 mg/dl [12.7 mmol/L]; one-hour – 143 mg/dl [7.9 mmol/L]; one-and-one-half-hour – 249 mg/dl [13.8 mmol/L]; and two-hour – 234 mg/dl [13.0 mmol/L]. I know that those are all high. Does the amount given to drink make a difference? The doctor had my son drink a whole bottle, but the label stated that children didn’t have to consume the entire amount. My son was feeling very sick, shaking, nauseated, and was very pale and sweaty after drink. Could this have made the test be inaccurate?

I do monitor my son at home because he has some of the symptoms of diabetes which seem to come and go. His fasting sugars are between 59-128 mg/dl [3.3-7.1 mmol/L]. Most of the time, he’s in normal range.

The doctors are saying that my son might have MODY, and I’m very confused with all of this. Please help.


From: DTeam Staff

Because of the family history and because it looks as though he might be overweight (I can’t tell for sure without knowing his height), I think that the doctor ordered the glucose tolerance test because he/she felt that your son might have some form of NIDDY (Non-Insulin Dependent Diabetes in the Young). The greatest number of these children have a disorder of insulin resistance which is essentially the same as type 2 diabetes in adults. it is a problem that seems to be associated with lack of physical exercise, being overweight and eating a diet that is overly high on ‘fast foods’. The incidence in younger age groups is increasing strikingly all over the world.

In your son’s case, because the A1c test and the fasting blood sugars have been normal, and the levels in the later part of the test abnormally high, I think these results might be attributed to an excessive glucose load (it should be 1.75 grams glucose/kilogram of body weight) or to the stress of the occasion. Nonetheless, I believe that he is at risk for this form of diabetes. It would be a good idea to start a diet which restricts free sugar and is low on carbohydrate generally as well as saturated fat. It would be wise to get help if you can from a pediatric dietitian to plan this so as to be sure that he still gets adequate vitamins and minerals. He would also benefit from a plan of organised physical exercise.

I rather doubt if your son has any of the five types of Maturity Onset Diabetes of the Young (MODY) In the first place, they only comprise 2-5% of NIDDY. In any case, the specific diagnosis requires some rather complex biochemical or chromosomal tests, and these are not usually done because of the expense and because the great majority of this group are easily treated with the same regimen as in type 2.