
February 6, 2007
Diagnosis and Symptoms
Question from Virginia, USA:
My daughter has been having dizzy spells and becoming pale at school, sometimes three times a week. They always occur between 9:30 a.m. and 10:00 a.m. The school nurse suspects hypoglycemia. Her endocrinologist gave me a monitor and told me to check her first thing in the morning and then at school, if she has a spell. This was only a few days ago. She has not yet had an episode at school, but the readings for the last four mornings are making me worry if maybe she has hyperglycemia. Do I have need for concern or are these ranges normal for a 10 year old? Her fasting blood sugars have been 143 mg/dl [7.9 mmol/L], 124 mg/dl [6.9 mmol/L], 138 mg/dl [7.7 mmol/L], and 113 mg/dl [6.3 mmol/L]. We are going back to the doctor in three weeks – but I’d like to have an answer before then.
Answer:
I am assuming that not only were you given a monitor, you were INSTRUCTED in its use. Too often, I see that patients forget to do some very basic but very important things when checking blood glucose:
Make sure the testing site (e.g., fingertip) is clean and DRY.
Make sure that the meter and code strip are set the same (some meters do this already but many still require manual calibration).
The meters are NOT specific enough to establish a diagnosis of diabetes. Please see some of the many, many, many questions on this web site pertaining to the Diagnosis and Symptoms of diabetes. One way to diagnose diabetes is to have a confirmed fasting SERUM (not meter-stick) glucose more than 125 mg/dl [7.0 mmol/L](or “126 mg/dl [7.0 mmol/L] or greater”).
While a couple of the readings you gave are suspicious, remember they were only done with a meter. Keep the dialogue open with your doctor!
While I, of course, agree that the way to better establish if low glucose is a cause for your daughter’s symptoms is to check her glucose level during a “spell,” I also typically ask such patients to check glucose levels before each meal and at bedtime for a while, to see if there are any predominant patterns.
DS