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August 25, 2003


Question from Spotsylvania, Virginia, USA:

My 17 month old daughter has had two episodes of shaking in the past two months. The first time just her hands were shaking, but the second time her whole body was shaking. Both occurred in the morning before breakfast, and when I gave her some juice, she recovered quickly. The doctor did a random glucose which was 55 mg/dl [3.1 mmol/L] and just wants to continue to monitor it without any further intervention, but I am concerned. Is 55 mg/dl [3.1 mmol/L] too low? What if this happened during the night, and I was not aware her sugar level had dropped?


A normal blood sugar is usually 65-110 mg/dl [3.6-6.1 mmol/L]. I would suggest reviewing your concerns with your pediatrician.


[Editor’s comment: Your concern is not unusual, and I assume you have been properly trained to use a home blood glucose meter for monitoring. Blood glucose levels should be checked whenever your daughter is symptomatic, and since you are particularly worried about nighttime lows, I would routinely check at bedtime to make sure her blood sugar is somewhere around 120 mg/dl [6.7 mmol/L].

While there are many causes for low blood sugar, children your daughter’s age most usually have a benign condition called ketotic hypoglycemia. Treatment consists of frequent small meals and snacks throughout the day, and most children will outgrow it.

If you do not know how to use a meter, I would request that your daughter’s physician refer you to a Certified Diabetes Educator who can train you in its use and proper treatment of hypoglycemia. In addition, I would also ask for a referral to a pediatric dietitian who can instruct you in a meal plan to avoid future episodes.