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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

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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