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From Arizona,USA:

I just read the Diabetes Team suggestion to read an article on milk in JAMA. Meanwhile, our doctor (NOT the endocrinologist) suggested we take our daughter off ALL dairy products because she doesn't metabolize them well. He's giving her a calcium supplement instead, bound with phosphorous, which he said will aid the integrity of the cellular walls. Our endocrinologist had a fit about it and we are torn. What literature is out there so we can make an informed decision?


The article in the JAMA that you refer to describes a recent study which suggests that early exposure to cows milk protein in infancy may not increase the risk of developing insulin dependent diabetes later on in life as suggested by others. If exposure to cow's milk protein in infancy does increase the risk of developing diabetes, it is not because these children have any difficulty metabolizing milk. If there is a problem, it is that somehow early exposure to cow's milk sets off an immune reaction against the pane to cow's milk sets off an immune reaction against the pancreas.

You didn't mention whether your child taken off dairy products had diabetes or not, or whether or not dairy products were removed from the diet to try and prevent diabetes or because your child was having gastrointestinal symptoms or allergic symptoms from dairy products (unrelated to diabetes).

The most common problem "metabolizing" milk is called lactose intolerance. In this condition, the individual is missing a chemical (enzyme) called lactase necessary to break down the sugar found in milk (lactose). The unmetabolized lactose may cause abdominal pain, gas, cramping, or diarrhea, often several hours after ingesting milk. Today, the missing chemical can be given in a capsule or drop form (Lactaid or Dairy Ease are some brand names) and the child can then ingest milk products without any problems. Milk can also be purchased with this chemical already added.

Less frequent is true allergy to milk products. In this condition, avoidance of milk products is necessary to prevent symptoms.

If your child doesn't ingest dairy products for any reason, calcium needs must be met from another source. It is best to discuss this with your daughter's doctor(s). If there is confusion, perhaps your doctors could speak directly to each other to clarify the issue.


Original posting 4 Oct 96


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