Question:
My eight year old son was diagnosed with severe ADHD. The doctors thought the cause to be partially due to severe allergies both food and chemical. Now because of certain behavior problems in and around mealtimes, they are questioning hypoglycemia. Could you please give me the normal levels I should be looking for when I do random glucose sticks on him?
Also have you heard or has there been any research done in this field.
Answer:
You do not tell us whether your child is diabetic, whether he has
had a trial of Ritalin for the ADHD, and whether you have already learnt
to do blood sugars by finger stick. In answering I am assuming that he is
not diabetic, that he has not done well on Ritalin and that you are able
to measure blood sugars.
The normal range of fasting blood sugars in children is quite
wide and goes from 60 to 105 mg/dl in a hospital clinical laboratory. If
you are using a visual strip like Chemstrips, bear in mind that there is
a tendency to read low.
Aggressiveness, irritability and to some extent poor attention
span are indeed characteristic of hypoglycemia; but your son is rather
old for most of the 'metabolic' forms of hypoglycemia to be presenting
for the first time. The symptoms and signs of hypoglycemia also
characteristically resolve fairly consistently with food intake. From a
distance, it seems more probable that your son is one of the 20% or so ADHD
cases that do not respond to Ritalin. I expect that you have already
discussed with his doctor whether he might profitably be tried on one of
the other drugs for ADHD or whether he could be a candidate for
behavioural therapy. Dietary modification, primarily the elimination of
food dyes (Feingold diet) was popular some years ago; but was never
convincingly effective.
There is a common behaviour pattern in children that is characterised by
extreme irritability before meal times and a very rapid response to food.
This is often called hypoglycemia; but the low blood sugars have not been
documented. It is beginning to be understood that some new hormones, not
just insulin and the counterregulatory hormones
like glucagon and epinephrine are involved in the body's very complex
metabolic response to food ingestion. It is possible that in the future
some of these abnormal behaviours will be attributable to problems with
Amylin and Glucagon-like-peptide, but at the moment there is little firm
information to help you with this very difficult problem.
DO'B
Original posting 30 Jan 97