Question from Massachusetts, USA:

My friend’s two and a half year old daughter had a severe low blood sugar after spending the weekend with my son who is insulin dependent and was diagnosed with a fatty acid oxidation (FAO) disorder. She needs to eat frequently, and her parents are trying to get her to go longer without meals during the night. She has yet to be sick since her original episode just over a year ago and her parents are planning to induce another episode at the hospital to determine the degree of her FAO.

Sometimes she wakes up around 3:00-4:00 am and vomits due to a stomach ache. A nurse suspected a low blood sugar, but I thought these symptoms might be more indicative of high blood sugar in diabetes. Her mom told me that some doctors don’t want her to use a blood meter since the reading could be fine and she could still be in danger. She was told to look out for ketosis.

Could the vomiting episodes be related to ketosis? Could she actually be in danger? Is the danger of ketosis from an FAO similar to that of diabetes? Does a high fat diet do the same thing for her that a high sugar diet without insulin would do for a child with diabetes?

Since my friend’s daughter hasn’t had the definitive test, her care has been in limbo. My friend has read about low fat diets for people with FAO, but her daughter’s doctor hasn’t recommended it. She also has very bad skin problems and is wondering if that is related to her diet. Any recommendations you have on this would be appreciated.