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June 24, 2007

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Question from Richmond, Indiana, USA:

What effect do growth spurts, 1 inch or more within a 30 to 60 day period, have on blood sugar levels? My son is 14 years old, 6 feet, 3 inches and still growing. We have a family history of diabetes on my wife's side of the family, including a maternal grandmother who became diabetic in her 30s and died at 53 from complications from the disease. My son's blood sugar levels have remained in the normal range for the past three years with diet and exercise. However, it appears that when a growth spurt occurs, his blood sugar levels become extremely elevated, 200 mg/dl [11.1 mmol/L] to 300 mg/dl [16.7 mmol/L], even as high as 400 mg/dl [22.2 mmol/L]. Though the levels are occasionally elevated, he does not display any of the expected symptoms (frequent urination, excessive thirst, etc.) Additionally, when I (his father) was this same age I had a urine sample for a school physical that was "off the chart" and I was immediately tested for diabetes. The tests were normal and I have never had any further difficulty with it some 35 years later nor is there any history of it in our family. At the time of this event, I was also going through a significant growth spurt myself. I am now 6 feet, 4 inches tall and have an amazing history of health on my side of the family, including grandparents living into their 100s and parents into their late 80s and still going strong.

Answer:

The high blood sugars you describe, although intermittent, are worrisome. This could be an early form of type 1 or type 2 diabetes or some other rare forms called MODY. You should discuss this with a diabetes consultant and determine how often to check, even without symptoms. You should also discuss antibody and genetic testing since this would help better establish risk. Any numbers as you describe, however, are definitely not normal although decisions about how to treat need to be individualized.

SB