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May 27, 2001

Diagnosis and Symptoms

Question from Hillsdale, Michigan, USA:

I have type�2 diabetes, and since my nine year old daughter gained seven pounds in one month, I tested a random blood sugar which was 167 mg/dl [9.3 mmol/L]. A fasting blood sugar was 148 mg/dl [8.2 mmol/L] and random evening blood sugars have been 299 mg/dl [16.6 mmol/L]and 332 mg/dl [18.4 mmol/L] on my meter. The doctor did a fasting test which was 74 mg/dl [4.1 mmol/L] and said my daughter was okay, but I am still worried about the high readings. Should I make her do more tests? If so, what tests should I ask for?

Answer:

I think that you should try to accept the normal blood sugar obtained in the doctor’s office as indicating that your daughter does not now have diabetes. At the same time, I am sure that you are concerned about the high fasting and random blood sugars that you have found at home and about the weight gain with its possible link to type�2 diabetes, an increasing problem in childhood. The high blood sugars at home could well have been due to a nonverbal communication of your own anxiety.

So to begin with and with the doctor’s or a pediatric dietitian’s help, you need to find out if your daughter really is overweight for her age in terms of her position on a standard weight/height chart or from calculating a Body Mass Index (BMI= Wt in Kg/Ht in meters squared). If she is, then it would make sense to do all you can to encourage physical activity and to increase fiber in her diet and restrict fast foods, etc. At the same time, and especially if there is documented evidence of obesity, you need to repeat the office fasting blood sugar at intervals to see if overt glucose intolerance develops.

DOB