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Suggestion on GLUCOSE, CREATININE, ALK PHOS, CHOLESTROL reports.

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Good Morning! my name is Valerie.
14yr old male
ht: 5'10" wt 21
recent labs fasting: glucose 100, creatinine 0.3, AST 14, ALK PHOS 215, Cholesterol 114, insulin 25.42

A1C- 5.9

I am wondering what your interruption of these labs results are and how or what your suggestion of follow up would be.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 19 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
So before I can make comments, I would like you to clarify a few things.
Is your weight 21? Is that 21 kgs or pounds?
The cholesterol value that you mentioned, is that total cholesterol or HDL or LDL or Triglycerides
The Alkaline phosphatase (ALP) is one of the lab values increased above normal. But considering your age, increased ALP is common during periods of growth spurt.
Also you A1C level is 5.9. An A1C level reflects how your body’s blood sugar has been over the last 3 months. Values below 5.7 are normal. A level between 5.7 and 6.4 indicates prediabetes.
However before I give any further opinion, kindly include in your reply what your normal diet consists of and whether you have a family history of diabetes. Also, do you have any symptoms I should be aware of or any significant past medical history ?
Hope this helps


Patient replied :

this is actually regarding my son. wt: is 212 . according to the lab results I am looking at ALK PHOS - 215 ( 250-850) normal range creatinine - 0.3 ( 0.6-1.3) AST - 14 ( 15-37) cholesterol 114 - (119-202) triglycierides, ldl, hdl all are w/i normal limits Insulin 25.42 (3-25) Yes, his grandfather is a diabetic. his diet is horrible, consisting of mainly junk food. he has on occasion complainted of burning feet. his knuckles occasionally turn purple. and he is forever hungry.


Thank you for the follow up.
Your 14 year old son, weight 212 pounds and height 5 feet 10 inches has a calculated BMI of 30.4 which places him in the obese category. A healthy BMI for a boy his age is 16.3 to 23.1. As you mentioned, his diet is contributable to the high BMI. During periods of growth spurt, it is quite natural for young boys to become hungry frequently. Therefore my first suggestion for you is to would be to encourage him to take up a sports activity which would motivate him to exercise for at least 30 minutes a day atleast 4 times a week. Additionally, his current diet has to improve, it must include servings of fruits and vegetables, minimal intake of fried foods and fast food options which are high in fat and sugar content.
Aside from that, the lab values you mentioned are normal. By way of numbers, the values are less than normal range but there is no cause for concern.
Hope this helps


Patient replied :

So you feel that his A1C of 5.9 is ok. If so when would you suggest a repeat.


Hello,
Thank you for the follow up.
As I mentioned in my previous reply, having an A1C level above 5.7 indicates prediabetes. Levels between 5.8-6.4 means that your son has a high likelihood of developing diabetes if his diet doesn't improve to become more healthy. I would recommend that you begin these changes as soon as possible and recheck your A1C 3 months later becase A1C is a reflection of your average blood sugar for the preceding 3 months.
Hope this helps,


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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