February 19, 2002
Diagnosis and Symptoms
Question from Conway, South Carolina, USA:
My nine year old daughter, who is small for her age (47 inches and 46 pounds), has been feeling shaky and sweaty and has chest pains and stomachaches every morning at school. After repeated visits to her pediatrician and several calls from the school nurse, she finally had a five-hour GTT during which the nurse cancelled the last hour and a half. A few days later, her pediatrician said her results were “extremely abnormal”.
She is producing too much insulin and has hypoglycemia. All her doctor really said from there was that she needs to take snacks to school were she will have access to them at all times, and I feel like I should have gotten much more information. I have asked her pediatrician for reasons, and more information, but he’s said he wants to do more tests first.
What Is hypoglycemia? How do I find out if she has diabetes as well? Why are they testing her growth hormone, thyroid, and hemoglobin?
Answer:
The issue is the relationship between you and your daughter’s pediatrician. I see that there seems to be a progression in diagnostic thinking by the pediatrician. Diabetes doesn’t seem to be the issue from what I can read. He is right to think about other causes, including problems with growth hormone, etc. There are other tests that look at insulin levels too which may need to be done. This is really more complicated than can be addressed here.
You should either let the diagnostic workup be completed or seek a referral to a pediatric endocrinologist.
LD
