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January 29, 2006


Question from Montreal, Quebec, Canada:

My son has recently been checked for high sugar counts and was 13.5 mmol/L [243 mg/dl] before breakfast. We are going trough some tests right now to find out what the problem is, but my question to you is: what are the normal sugar counts for a child before and after meals? This is very important to me for I recently found out I, too, am diabetic and it runs in my family as well as my husband's, so I have been told that this is most likely a genetic thing. The problem is that my son. who is seven years old, weighs 120 pounds at 4 feet, 6 inches. He may have Prader Willi syndrome. This little guy is active and nowhere near a couch potato. My older son, who is fine is 12 years old, 95 pounds at 5 feet 2 inches and eats like a pig. Plus, he is a couch potato. They are two different children yet they come from the same environment. My out-laws are always looking to blame me for his illnesses and I just want to do what is right for MY son. They tell me it is what he eats that makes him diabetic; is this true? Can sugar products raise your sugar to the point of diabetes? I want to make better choices and, to tell you the truth, we are not horrible eaters. We just have very busy lives and sometimes faster is easier. I am going to do my best to help our family with this problem, but I would be nice to be fully educated.


Blood glucose levels are normally in the range of 4 to 5.5 mmol (about 72 to 99 mg/dl) before eating and, after eating, may rise as high as 7 mmol/L (approximately 126 mg/dl). Occasionally, values would be slightly lower or slightly higher depending upon specific food, activity, illness etc. By two hours after food or drink intake, the postprandial blood glucose values return back to the pre-food normal levels; same overnight. Being overweight is a major risk factor since the pancreas often cannot make sufficient insulin to balance energy needs. So, whether or not your child has Prader Willi Syndrome, his obesity sounds like the key factor to overcome.

If your younger son has Prader Willi Syndrome or something similar, we believe this is a metabolic abnormality involving the brain and hypothalamic area where satiety centers are not working well. But, research about this is still very primitive and not yet clinically applicable very much. If he has a 15q gene deletion found in Prader Willi, it would explain his obesity but the treatment still involves fewer calories in and more being burned off. If he really is active, then he needs fewer calories. No matter what he is doing, more vigorous activity each day would also be helpful i.e., less television, computer and computer game time. Treadmills, exercycles, Dance Dance Revolution, walking, as well as all sports (bicycle, football, soccer, swimming) need to be increased. You should return to your medical team and seek their specific advice about ways to increase activity (burn more calories than currently happening) and cutting calories (less liquid, less sugar, less fat, smaller portions, etc.) since that is the only chance that you have to control this if weight excess remains the key problem.

Two children often have major genetic differences so this is not so surprising. Genes are distributed randomly with each conception, of course, and usually are not within our ability to control.