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Question:

From Santa Maria, California, USA:

Our son is extremely small and underweight. We went to a pediatric endocrinologist who, after a year of tests, put him on Increlex or IGF-1. On Increlex, we had to monitor his blood sugar because the medicine can LOWER it. However, since he has been on the medicine, his blood sugar has been getting higher. His average is 152 mg/dl [8.4 mmol/L], but has been 350 mg/dl [19.4 mmol/L], 232 mg/dl [12.9 mmol/L], 161 mg/dl [8.9 mmol/L] and so on. Our doctor had us stop the Increlex six days ago and our son's blood sugar has returned to normal in the morning and early in the day but has still been above 120 mg/dl [6.7 mmol/L] seven times in five days. Those readings were 146 mg/dl [8.1 mmol/L], 133 mg/dl [7.4 mmol/L], 136 mg/dl [7.6 mmol/L], etc. I am reading that these readings are above normal. Can he be diabetic if he is normal part of the time? Our doctor says it is impossible, that it is the Increlex but hasn't told us what else it could be. He just keeps telling us to keep checking his blood sugars six times a day until we go back to him. I am a little concerned and asked if we needed any further tests, but he said no.

Can he be developing diabetes? He just turned 11 last month and is the size of a seven-year-old. He has weighed 58 pounds for the last three years. Could diabetes be hindering his growth and weight? Could this have been the problem all along?

Answer:

It is unlikely that diabetes is causing the short stature. IGF-1 can be associated with hypoglycemia but it is odd that there has been high sugar levels even if intermittent. So, I would also be worried that he is developing diabetes and would have you do exactly the same thing: frequent blood sugar monitoring, call if the levels were rising/worsening and certainly if there were symptoms (enuresis, excess urination in general, excess thirst, weight loss). Testing for beta cell antibodies (islet cell, GAD-65, IA2, Zn8) would also provide some information about any autoimmune process that is going on. Stay in close contact with your pediatric endocrinologist and report changes or concerns, of course, between visits.

SB

DTQ-20090407163726
Original posting 2 May 2009
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:10:18
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