July 20, 2008
Diagnosis and Symptoms, Hypoglycemia
Question from Fort Worth, Texas, USA:
My daughter has had several possible hypoglycemic episodes. Once, she ate a doughnut for breakfast and, at almost lunch time, she was very cranky (very unlike her) and threw big fits. I tried feeding her. She ate a cracker or two without any change, but when I gave her a sip of my soda, minutes later, she was much better. Then, another time, she had a cookie at snack time and around one and a half hours later, she was shaking. We fed her, and minutes later the shaking was gone. This has happened other times, too. Because I was diagnosed with hypoglycemia in college, I took her to the nurse practitioner at the pediatrician’s office. She took her blood sugar that day just at a random normal time and it was 78 mg/dl [4.3 mmol/L]. Then, they sent us to get a fasting blood test the next week. She had no symptoms at the time they took the blood and I got a call a couple days later saying she was fine. I had asked how this fasting blood test was going to work anyway since she has mainly shown symptoms after eating sugar, but they assured me this would tell them what they needed to know. They also mentioned they would need three fasting tests in order to diagnose hypoglycemia but, after they did the first test, they didn’t try to schedule any others anyway. I feel like I’ve been completely ignored. Should I just ignore the symptoms I have witnessed or be more pushy about getting some answers? Or, should I just make sure I always have good snacks available? What test should they do in order to test for hypoglycemia?
Answer:
It could be hypoglycemia or just could be some “mis-signaling” of her autonomic nervous systems. The good news is that both usually respond to staying away from simple sugars and simple carbohydrates, always eating something no more than three hours apart and making sure that there is protein and fat in every snack – not just carbohydrates. If you like, you can do finger stick blood glucose (BG) levels at home with one of the many home glucose meters that people with diabetes use. BG levels above 60 mg/dl [3.3 mmol/L] are okay. One would assume, if this really were hypoglycemia, that you could document BG values in the 40s mg/dl [2.2 to 2.7 mmol/L] or 50s mg/dl [2/8 to 3.2 mmol/L] and then, when treated with simple juice or soda containing sugar, the symptoms would respond within 10 to 15 minutes. You should bring this information to your physician and review it with them.
SB
