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June 23, 2002

Diagnosis and Symptoms, Hypoglycemia

Question from Canyon Lake, California, USA:

My almost four year old adopted son was born to a mother who had gestational diabetes, and he was hospitalized for one-two months after birth for hypoglycemia. He came to me at 16 months of age, and I have seen him have completely irrational, crazed, angry behavior, which is very out of character for him. When this happens I have to force some sugar into his mouth. After he gets some sugar, candy, juice or whatever into his system he's back to normal within a few minutes. I've taken him to two doctors about this problem who have both said that hypoglycemia at birth is generally resolved soon after birth and his fits are most likely just typical temper tantrums. Does this sound like he could still have hypoglycemia? If so, why would he still be having trouble with it? Also, his biological sister was diagnosed with hypoglycemia at an older age. She has had convulsions and brain damage because of it. The biological mother had gestational diabetes with her as well. Do you have any information about how children born to diabetic mothers tend to fare? What problems they tend to have over the years because of it?

Answer:

I don’t think that your adopted son’s hypoglycemia is connected to his mother’s gestational diabetes. Even though you only now have circumstantial evidence that these episodes of abnormal behaviour are due to hypoglycemia, he did have verified hypoglycemia in the neonatal period, and there appears to be a sister with a similar problem.

In these circumstances I don’t think that you should accept that these are just episodes that he ‘will grow out of’. There are a number of uncommon inborn errors of organic acid and fat metabolism that could present just like this, and, in the light of this history, they should be excluded. If they can be identified, treatment could prevent the damage that his sister appears to have suffered. I would ask the pediatrician for a referral to a metabolic group that has access to the special laboratory facilities needed for diagnosis.

DOB