August 15, 2008
Diagnosis and Symptoms
Question from La Vergne, Tennessee, USA:
My daughter, 6 years 10 months old, has always had severe mood swing to where no one wants to be around her; we call them her meltdowns. About the time she has a meltdown, her stomach starts to hurt. For the last two years or so, she has always been thirsty, hungry and wetting the bed at night after being dry at night for about a year. We have a family history of pancreatitis both in me and my father. My father was a type 1 diabetic due to all the pancreas damage. Several family members have type 2 diabetes. One day, just being curious, I tested her sugar level and it was 140 mg/dl [7.8 mmol/l] first thing in the morning. I immediately called her pediatrician and she said the watch it over the holiday weekend and call her back.
Over the weekend, my daughter’s blood sugar was high a few time but not reaching 200 mg/dl [11.1 mmol/L] so I changed her to a very low carbohydrate, low sugar diet and she stayed well with in normal ranging from 80 mg/dl [4.4 mmol/L] to 115 mg/dl [6.4 mmol/L]. Her doctor say she was fine and to forget about it.
So, I changed her diet back to normal and she again had an immediate meltdown and stomach pains and her sugar was 167 mg/dl [9.3 mmol/L], again first thing in the morning. I have since changed her back to a low carbohydrate/low sugar diet and she seems to be fine. I have an appointment with a new doctor to see what he thinks. Are these symptoms something that I need to worry about?
Answer:
It could be hypoglycemia and this sometimes, rarely, precedes the development of type 1 diabetes. You are probably treating the hypoglycemia by cutting back on carbohydrate intake. If this were simple hypoglycemia, treatment would usually be three meals and three snacks and always having something with protein and fat – rather than simple carbohydrates – at each of these six feeding times. Also, she should never go more than two to three hours between food. This works about 95% of the time. It would be quite reasonable to consult with a pediatric endocrinologist who has experience in and is interested in hypoglycemia since they can advise you about antibody testing for diabetes, how often to check blood glucose levels, etc. Also, it would be important information to get blood glucose levels during these “meltdowns” to see if they really are hypoglycemia (for example, if blood glucose levels below 60 mg/dl [3.3 mmol/L] during these emotional episodes or not).
SB
