May 27, 2004
Diagnosis and Symptoms
Question from Hartland, Vermont, USA:
My five year old son recently had a tonic clonic seizure lasting about 15 seconds. He had a normal EEG. He sweats profusely at night so I thought he might be experiencing hypoglycemia. However, testing him while asleep gave me high rather than low readings. Since I have type 1 and am very proficient at home blood glucose monitoring, I tested my son, who is adopted. Testing during the night over a couple of weeks, I have seen a number of high results with a maximum of 225 mg/dl [12.5 mmol/L] one hour after a meal. I was only able to test at one hour that one time. When he gets high, which doesn’t always happen, it takes five to six hours past eating for his blood glucose to come down below 100 mg/dl [5.6 mmol/L]. Last night his results were: two hours–178 mg/dl [9.9 mmol/L]; three hours–150 mg/dl [8.3 mmol/L];four hours–130 mg/dl [7.2 mmol/L];five hours–125 mg/dl [6.9 mmol/L]; six hours–98 mg/dl [5.4 mmol/L]. The two waking readings I’ve gotten were 94 mg/dl [5.2 mmol/L] and 98 mg/dl [5.4 mmol/L].
His pediatrician has told me not to worry about these results or the profuse sweating. She has offered to do a fasting glucose test, but I think that will be normal. Should I be pushing for a GTT and antibody testing? Or do you agree these results are normal?
Answer:
The results you suggested for someone without known diabetes are suspicious, but not diagnostic with home monitoring machines. I would suggest more monitoring of routine blood glucoses for several days pre and postprandially to see what normal blood glucose excursion are like during regular activity and meals/snacks. Also, a more formal glucose tolerance evaluation and perhaps consultation with a pediatric endocrinologist would be helpful to sort this all out. Antibody testing for diabetes would also be reasonable. It is unlikely the seizures are part of diabetes with this information. Fever/illness associated, perhaps?
SB
