My seven year old son was diagnosed with type�1 seven months ago. Since the beginning, he has been able to tell when his sugar is going low, because his neck gets hard/tight and hurts. Do you know what is causing this feeling? Does the lack of glucose make the muscles constrict?

The variety of symptoms and signs of low blood glucose never ceases to amaze me. I have never heard of this particular symptom before. For many folks, their own symptom of hypoglycemia tends to be recurrent for them. For example, some folks rarely experience a hypoglycemic seizure and for others, this occurs commonly.

I could construct a situation that could lead to muscle contraction: as the glucose level decreases under the effect of insulin, this is accompanied by changes in the potassium environment in and out of the muscle cells. Leg cramping, for example, is often a complaint of patients with poorly controlled diabetes. Could this play a role with your child? I don’t know, but I’m glad he has a “built-in alarm” for hypos.

DS