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July 31, 2011

Hypoglycemia, Other Illnesses

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Question from Bendigo, Australia:

Now two, my child was born with transient neonatal diabetes. She no longer requires insulin but her hunger is insatiable and today she had a blood glucose of 1.2 mmol/L [22 mg/dl]. For a child that is nondiabetic, is this still considered hypoglycemia?

Answer:

From: DTeam Staff

Hypoglycemia is anything below 60 mg/dl or 3.3 mmol/L. The classical definition includes symptoms or signs as well as same time documented low blood glucose measurement. The most common error is not enough blood on the sample strip so it is important to double check especially if there are no signs or symptoms. So, it would be important to get a series of blood glucose readings every two to three hours at least throughout the day – perhaps some also at night – to make sure that there are no asymptomatic hypoglycemic or asymptomatic hyperglycemic occurrences. Either way, I would also suggest you discuss this with your endocrine team for their more specific and individualized advice.

Unrelated but important would be to know if your child has had free genetic testing to see what type of neonatal diabetes is present since such genetic testing would also give you some expected natural history, treatment options and follow-up plans needed. This is available free of charge via Professor Andrew Hattersley ISPAD co-sponsored laboratory in Exeter UK.

SB