April 8, 2013
Diagnosis and Symptoms, Hypoglycemia
Question from Columbia, Missouri, USA:
My 13-year old daughter was diagnosed with type 1 diabetes two years ago. At that time, we participated in the TrialNet program to see if any other family members have the genes that carry type 1. The results came back negative for my now 16-year-old son, but we were told he should be tested each year. We did not get tested this year as TrialNet was not at our local JDRF retreat where we were tested before. My son has been having symptoms of hypoglycemia after exercise. Today, he shoveled snow and came in asking for a snack. My daughter thought he looked low and tested his blood sugar. He was 55 mg/dl [3.0 mmol/L]. We treated him as we would treat our daughter for a low. Is there any link between hypoglycemia and undiagnosed type 1 diabetes? Is this something I should be concerned about or is it just something that happens to some people when exercising?
Answer:
Sometimes hypoglycemia occurs before the demise of the beta cells (i.e., before full fledged diabetes develops) so it would be important to get some blood glucose levels before and after eating for a few days to see if there were any abnormal values above 140 mg/dl [7.8 mmol/L] after eating and above 100 mg/dl [5.6 mmol/L] before eating. If so, you should contact your local diabetes team and review your son’s history with them. They will likely want an A1c test and perhaps repeat some antibodies. We suspect this represents the beta cells beginning to be damaged and mis-responding to glucose signals. If the genetic tests done previously were high risk, then the random hypoglycemia would be more suspicious than if the genetic tests were different (discordant).
SB
