When should you check to see if your child has a sugar imbalance? Diabetes is called "the silent killer", because often there is no warning sign, left undiagnosed until it's too late. In addtion to death, complications from diabetes include heart attack, stroke, amputations, blindness, kidney failure, and nerve damage. Since insulin resistance precedes diabetes (high blood sugar), high insulin level is our warning sign that diabetes may follow decades later. Don't ignore this for yourself or your child!

Children and adolescents with type 2 diabetes are more likely to also have high blood pressure, lipid imbalances, and non-alcoholic fatty liver disease (NAFLD).  These conditions may occur before the diagnosis of type 2 diabetes and, like type 2 diabetes, are also associated with being overweight or obese.   

The stage of elevated insulin levels is called pre-diabetes, which precedes diabetes (when blood sugar levels remain high). How do you know if you have high insulin levels without testing? Elevated insulin levels is often accompanied by increase belly fat, fatigue after meals, sugar cravings, and high blood pressure. Other lab abnormalities that go hand in hand with elevated insulin include lipid imbalance, as well as blood clotting problems and inflammation.

Diabetes and pre-diabetes are reversible with diet and lifestyle modification. The name of the game is to diagnose and treat pre-diabetes to prevent diabetes all together. We don't want to wait until the we have the disease to treat the disease. So with testing we want to identify not only diabetes, but pre-diabetes, as well as any associated diseases.

Diabetes or pre-diabetes? 
Measuring glucose and insulin levels will give the answer. It's important to measure BOTH after a 8 hour fast and then again 2 hours after a glucose challenge.

Another helpful test to diagnose diabetes is called Hemoglobin A1C, which measures glycated hemoglobin or glucose attached to hemoglobin. This test gives an idea of the average blood glucose over the previous 8 to 12 weeks. Glycated proteins create inflammation throughout the body, so it is also an indirect measure of inflammation (see inflammation below). A Hemoglobin A1C ≥ 6.5 percent is considered diabetes.

Lipid Imbalance
Lipid imbalances often co-exist with diabetes and pre-diabetes. HDL ("good" cholesterol) less than 40 and triglycerides over 150 is suggestive of a co-existing sugar imbalance. 

Non-Alcoholic Fatty Liver Disease
Insulin resistance causes fat to accumulate in the liver cells, leading to inflammation, fibrosis and eventually cirrhosis in up to 20 percent of patients! This can be reflected in liver function tests, which include:

*enzyme tests (serum aminotransferases [ALT and AST], alkaline phosphatase, and gamma glutamyl transpeptidase)
*tests of synthetic function (serum albumin concentration and prothrombin time), and
*serum bilirubin, which measures the liver's ability to detoxify metabolites and transport them into the bile.

Inflammation
A couple non-specific markers of inflammation include C-Reactive Protein (CRP) and ferritan levels.  Inflammation is both a cause and result of insulin resistance and diabetes.  Though these markers are not specific to inflammation from sugar imbalance, it does give a marker of the inflammation associated with the disease. 

Susan McCreadie, MD is a Holistic Pediatrician and co-founder of nourishMD. She shows parents how to find REAL health for their child, so they can stop treating their child's symptoms and instead find solutions that help their child heal from the inside out.