From Fort Worth, Texas, USA:
I have asked a question before and you were most helpful with the answer.
My son has had several health problems and we had noticed he drinks a lot, but never wet through his diapers or anything. The thirst was the only thing. He has failure to thrive and gains weight very poorly. I have type 2 diabetes so I monitored his blood sugar for awhile. His fastings seemed to be mostly normal, with only one or two above 100 mg/dl [5.6 mmol/L] but below 126 mg/dl [7.0 mmol/L]. I think 117 mg/dl [6.5 mmol/L] was the highest, but they were and have been, for the most part, good. He had several in the high 100s mg/dl [9.4 to 11.0 mmol/L], including one 189 mg/dl [10.5 mmol/L] and one 217 mg/dl [12.1 mmol/L] so I called his pediatrician. They did a fasting fingerstick with a monitor and got a reading of 99 mg/dl [5.5 mmol/L] and no sugar in his urine. The doctor told me to monitor him for a couple of weeks and then she would like to see those numbers.
I did an at home A1c one time to see what it was since I pricked his finger anyway for the monitoring. It was 4.4, which I know is good, so I didn't worry about it much. His sugars still ran the same range when I took her his log. The doctor decided to go ahead and do a fasting laboratory draw and an A1c. They came back as 79 mg/dl [4.4 mmol/L] for the fasting and 5.2 for the A1c. So, she said he was fine and not to worry about it. I stopped monitoring for awhile.
About a month ago, my son was lethargic when I went to get him out of bed. I checked his blood sugar and it was 40 mg/dl [2.2 mmol/L]. I re-checked after making sure his hand was clean and it came back as 41 mg/dl [2.3 mmol/L]. I gave him a Pediasure and it came up to 263 mg/dl [14.6 mmol/L]. I started to monitor his blood sugar again and there were many more in the 217 to 265 mg/dl [12.1 to 14.7 mmol/L] range than there were the last time I monitored.
Three days ago, when I was at my neighbor's and going to lunch, we found my son on the floor having a seizure. My neighbor drove and, on our way, I checked his blood sugar and it was 149 mg/dl [8.3 mmol/L]. He had a very early breakfast due to school starting and having to get my other kids there and took a nap at her house. My neighbor said my son didn't eat anything. I told the doctor about his blood sugar problems and he never checked his sugars. He said if he bottomed out, my son would need medical help to get his sugar back up. My pediatrician said that he could have bottomed out and his body could have kicked in stores of glucose giving us the higher reading. His blood sugars still go all over the place, the highest being 288 mg/dl [16.0 mmol/L]. He had one that was 133 mg/dl [7.4 mmol/L] at 3 a.m. and, that morning, he had a higher fasting but was still below 126 mg/dl [7.0 mmol/L]. The pediatrician said he only showed trace sugar in his urine, but feels he needs to be seen by an endocrinologist which is what I have been wanting anyway. Could the seizure been caused by a low sugar? When I go to the endocrinologist, what should I ask them? Should I take his monitor? Does he sound like he has diabetes? Should his thyroid be tested also due to the failure to thrive? Also, the A1c was higher even though I don't know how accurate the at home test can be. The seizure scared me to death. They are also doing an EEG and MRI. I just want to know what is going on with him. I truly don't want him to have diabetes. He already wears glasses and I don't want anymore damage to his eyes. I have noticed he has begun throwing his glasses off all the time. My concern is that he has diabetes but the laboratory tests are normal.
Convulsions are certainly scary! I hope your son does well.
I was able to review your original question from earlier this summer. Were you ever able to follow through with some of the suggestions and/or discuss them with your pediatrician?
There are a myriad of potential things that could lead to a child having a seizure. And, while the potential perturbations in glucose that you may have documented cannot be ignored, I think the real salient points about your child that stand out include the history of increased thirst along with the history of failure-to-thrive. With the new finding of his having a seizure, I think your child warrants a careful and complete history and physical examination.
The low glucose could lead to a seizure. This story does not seem typical of diabetes. Yes, take the child's monitor to the consultant. (But, if other individuals have glucose levels recorded on this device, it won't be as helpful.) As for specific tests to discuss or request, why don't you let your consultant decide based on the previous test results, EEG, MRI, and the child's history and physical examination.
Original posting 8 Sep 2009
Posted to Diagnosis and Symptoms
Last Updated: Tuesday April 06, 2010 15:10:18
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