March 19, 2001
Hypoglycemia
Question from St. Albert, Alberta, Canada:
My 16 year old daughter was diagnosed with type 1 diabetes at age six. Recently, she attended a wake-a-thon which required staying awake all night. We had planned carefully, adding several extra blood tests and lots of extra food to accommodate the extra activity. The following day, I woke her two hours after she had been asleep and her blood sugar was 8.6 mmol/L [155 mg/dl]. An hour and a half later, when I woke her for lunch, she seemed perfectly fine, but when sat down at the table, she started shaking. I gave her two spoonfuls of honey and then she went into a full seizure. I called the paramedics who gave her with intravenous glucose and oxygen, and took her to the hospital for a few hours of observation. Does sleep deprivation lower her resistance to seizure? She had one febrile seizure as a baby. Could this indicate that she is more likely to have seizures? Her lips turned blue during the seizure. Is there a risk of respiratory failure during a seizure requiring CPR? How typical is it for a person with diabetes to have a seizure with a low blood sugar instead of just passing out?
Answer:
Sleep deprivation does lower seizure threshold, but is not likely really clinically significant in most people with one night’s worth of missed sleep.
Febrile seizures as a child generally have no long term effects. So, that possibility is probably not the cause.
Her blue lips do suggest partial lack of oxygen.
Seizures are a common part of severe hypoglycemia. I suspect your daughter had a lot of activity during the wake-a-thon, and the effects of exercise reached into the morning. Even though your daughter blood sugar was 8.6 mmol/L [155 mg/dl], it was on the way down. All in all, I think she was going low from the exercise and did the same all the way to a seizure.
LD
