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September 20, 2000

Complications

Question from Groningen, The Netherlands:

Our 18.5 year old son has had type 1 for seven years. His blood sugars are in good control, but throughout the years we, as parents, have the conviction that he's not doing well because of constantly abnormal soft stool, not well developed tooth-enamel, and his small stature (18.5 years: 1.75 meters as compared to: mother: 1.72 meters, father 1.86 meters, brother (15years) 1.80 meters) These facts have been confirmed by his endocrinologist to the family-doctor, but besides a research for sprue which seems not to be the case, they do nothing with the facts. So we would like to ask you the following: Could this be something like malabsorption? Is there a relationship between type 1 and malabsorption or something like inadequate production of digestive enzymes? Could there be a relation between a correct digestive process and his actual blood sugars? We have the impression when he takes some digestive enzymes with his meals, blood sugars do better. What can we do to get more clearness in these questions?

Answer:

I’m sorry. This sort of case requires much more detail than you have provided. I am sure that your son’s doctors will have checked him for celiac disease. This and the sprue you mentioned are causes of malabsorption. I am also unclear why your son would be taking oral digestive enzymes unless a specific diagnosis has been made. My advice would be to ask his current doctor for an explanation of what he thinks is going on, and if you are unhappy with this, then seek a second opinion.

All of this presupposes that your son is compliant with his diet and insulin regimen.

KJR