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September 23, 2002

Diagnosis and Symptoms, Meal Planning, Food and Diet

Question from :

Recently, an endocrinologist saw my son and said he has pre-diabetes and what was called metabolic syndrome. He wants him to go on only 5 carbs a day and the Atkins' diet. Can me any information on this? His fasting glucose was 117 mg/dl [6.5 mmol/L] with an insulin level of 87.


Your son’s fasting blood glucose level was in the impaired glucose tolerance or prediabetes range, but a single assay might well be due to stress and needs to be repeated. You don’t say if he is overweight and if his blood pressure is normal which are features of the metabolic syndrome

For a review of the advantages and disadvantages of the Atkins’ diet you might wish to look at Dr. Atkins’ dietetic revolution: a critique Schweiz Med Wochenschr 1977 Jul 23;107(29):1017-25. If the insulin level was reported in microunits/ml and not in pmol/L then the figure is high and would corroborate a degree of insulin resistance.

Additional comments from Joyce Mosiman:

I have some real problems with putting children on the Atkins’ diet. In fact, with the 5 carb order he would be on 60 grams of carb a day. and it would not be possible meet the recommended daily allowances for fruits, veggies, and milk.

I would more likely recommend limiting the carb at each meal and avoid drinking/eating high sugar foods and highly processed foods such as pasta, low fiber cereals, etc. Unfortunately I don’t think there are many guidelines out there for hyperinsulinemia and pre-diabetes. I would think that exercise and eating more fresh, fewer processed foods might have been a bigger emphasis.

Additional comments from Jane Seley, diabetes nurse specialist:

The American Diabetes Association recommends carbohydrate counting as the preferred method of meal planning. This method of meal planning provides a great deal of flexibility and allows for balanced, healthy eating. Since your son has pre-diabetes and will have to follow a meal plan for many years to come, I would recommend he consult with a registered dietitian to learn more about this option.