From Caldwell, Idaho, USA:
My two and a half year old son, who has celiac disease and a strong family history or diabetes, has had elevated blood glucose levels for six months now. According to his meter and the records I have kept, out of 67 checks in the last few months, 38 were within the normal range of 70 to 120 mg/dL [3.9 to 6.7 mmol/L]. There were also 29 documented occasions when his blood sugar was elevated, between 180 and 400 mg/dL [10.0 and 22.2 mmol/L], including one reading at 412 mg/dL [22.9 mmol/L] and several fasting levels near or over 200 mg/dL [11.1 mmol/L]. He always manages to come down from these highs on his own within a few hours. His endocrinologist has told me that these numbers are definitely not normal but, there is nothing we can do for them. Is this true? Is there really nothing that can be done to either control his blood sugars now or prevent the possibility of diabetes in the future? He obviously feels the effects of these of blood sugar levels and I hate to see him miserable. Isn't there anything that can help him?
I am afraid that we are just not that intelligent to know what is going on with your son. Such intermittent hyperglycemia that self-corrects sounds like some beta cell problem, but giving insulin would not help much since the self-correction fixes the problem. You are wise to keep monitoring, particularly if there are symptoms or during episodes of illness. There are some researchers and clinicians (me included) who believe that limiting simple carbohydrate intake would be wise since this would place less general demand on the beta cells, but this is especially difficult if also following a gluten-free celiac regimen since many of the complex carbohydrates are already eliminated. High fiber vegetables would be okay and any slow carbohydrates that are permitted on gluten-free schedules would be preferable. There is even some research that suggests avoiding gluten may also help prevent type 1 diabetes as well. But, all this is very general and not very specific. Staying in close contact with your endocrinologist would also be wise with periodic A1c levels, antibody testing, etc.
I have recently given two talks at international meetings, one in Italy and one in Romania, and summarized the current state of affairs regarding association with diabetes and celiac disease so I'm afraid there is a lot of speculation but not much specific treatment yet available.
Original posting 15 Nov 2005
Posted to Diagnosis and Symptoms
Last Updated: Tuesday April 06, 2010 15:10:04
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