August 27, 2007
Diagnosis and Symptoms
Question from Charleston, South Carolina, USA:
Born five weeks early, one of my five-year-old twin sons had a problem maintaining and regulating his body temperature at birth. He has had some developmental delays and speech delays and is said to have a mild mental retardation. He has also had a hard time gaining weight and at weighs only 35 pounds. He eats fairly well for his age, but we have always chalked it up to a high metabolism like his father because his father is skinny and has a hard time gaining weight, too.
A few months ago, my son had a petit mal seizure or so, the school said. Basically, he just “fell out” at school. After going to the Emergency Room and giving him cookies and juice, he started acting “normal” again and they just sent us for an EEG. The results were said to be normal.
Today, he slept from 9 p.m. last night until 3 p.m. I’m in the process of moving, so I had been busy all day and realized he wasn’t up playing with his brothers. I got him up and he sat in the living room and fell asleep again. I tried getting him up and all he said was he was tired. He always looks pale because he is fair complected with white blonde hair and blue eyes. I gave him some sips of a soda and then a few minutes later I checked his blood sugar, which was 61 mg/dl [3.4 mmol/L]. Is this reading normal for his age and weight or is that low?
When I was pregnant with the twins, I had gestational diabetes. Type 2 runs in my family, but I don’t know about type 1.
Answer:
One has to wonder if he doesn’t have ketotic hypoglycemia. This is a fuel problem seen in children. It is seen especially in young and small children. Basically, they run out of fuel and become hypoglycemic. Because they run out of fuel, they start to burn fat and create ketones. When they are found to be hypoglycemic, the urine has ketones, a very useful clincal sign. I wonder if this isn’t the case here because he went to bed early and slept late. The 61 mg/dl [3.4 mmol/L] isn’t low for a child, but you had already fed him.
Fortunately the treatment is easy…food. Be sure he has snacks. You can even check the urine for ketones in the morning to be sure he is eating enough at bedtime. Children outgrow this with time.
Be sure to ask your pediatrician for advice.
LD
