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August 28, 2013

Diagnosis and Symptoms, Hypoglycemia

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Question from Calgary, Alberta, Canada:

I have had type 1 diabetes for almost 30 years. I have three children, my oldest being almost 5 years old. Lately, he has been acting off, tired, weepy, etc. Today, I decided to check his blood sugar to see if were high since I am paranoid one of my kids will get diabetes! To my surprise, he was actually low, 3.0 mmol/l [55 mg/dl]. I gave him some juice and he acted normally again. How concerned should I be? Should I take him to the doctor after just one episode? He ate lunch at 12:15 and I tested him three hours later. Could this be linked at all to diabetes or is his hypoglycaemia linked to me having diabetes?

Answer:

One slightly low blood sugar value does not quite confirm a diagnosis but it raises questions and suspicions. There are some periods when the pancreas is about to fail when it will produce some extra insulin, thus there might be some mild episodes of hypoglycemia, sometimes preceding developing insulin deficiency and diabetes. So, it is important to get a series of blood glucose levels just before eating and 1 to 2 hours after eating for a dozen or so meals and see what numbers you obtained. For sure, if the symptoms recur, check the blood sugar before automatically treating what seems like hypoglycemia as well. If there were any question of these results or if symptoms change or remain puzzling, then you should consult your pediatrician and perhaps get a consultation with Dr. Heather Dean in the pediatric endocrine/diabetes clinic. Testing for islet cell antibodies of several different kinds and perhaps some genetic susceptibility testing may be available to help sort this out as well. But, get the blood sugars checked first for the next few days.

SB