December 24, 1999
Question from Eagan, Minnesota, USA:
My daughter has had diabetes for 15 years. She is 16 years old and has always been brittle. The last couple of years have seen more problems with high blood glucoses than lows. She complains of being tired and says she often feels like she will pass out (not due to getting up too fast). This has gotten worse in the last few months. She says she feels this way most of the time. Her blood sugars are not low when feeling like this. We have checked her for anemia and low thyroid but these tests were normal. Can you think of anything else that should be looked into?
I don’t have a good answer, but perhaps it would help for her to have a cardiac evaluation with a tilt test to see what happens under a controlled situation when she is slowly tilted to the upright position or to wear a device called a Holter monitor to see if she has episodes of irregular heartbeat.
Additional comments from Dr. Quick:
Dr. Lebinger’s suggestions are looking for possible causes that are unlikely to be related to your daughter’s diabetes, although there is a possibility of something called “postural hypotension” that could be due to diabetic autonomic neuropathy.