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February 18, 2000

Hypoglycemia

Question from Stockholm, Sweden:

My 3 year old daughter was diagnosed type 1 six weeks ago. We have not been checking her blood sugar levels at night at first as we were told this was not necessary. Her levels have been around 6-7 before bed, and 3.5 - 5 when waking. I checked her last night at 2 A.M. and found she was 3.1. I gave her bread and milk and she was 8.7 in the morning. It seems probable that she has been too low at night for the past few weeks! How would this have affected her? Could this explain why she still does not look 'well' despite the well controlled day time levels?

Answer:

If your child does not look well, then make sure you talk to your doctor about this. As far as screening for lows overnight, I do usually recommend blood glucose monitoring at bedtime to my patients, as well as some middle of the night checks. Concerning middle of the night numbers during the honeymoon period, you may find them in the normal range. The remaining islet cells can keep the blood sugar in this range when the child is not eating overnight. Using a home blood glucose meter, it is not always easy to tell the difference between a low and a normal reading.

LM