March 16, 2004
Diagnosis and Symptoms, Honeymoon
Question from Mineral, Virginia, USA:
My grandson, who is seven, has had tonic clonic seizures, about four a year, usually in sleep a couple in the day. I thought it odd that he had terribly high blood sugar after a seizure; it was over 400 mg/dl [22.2 mmol/L]. I asked the old neurosurgeon about this and he said that kids don’t get diabetes. The new neurosurgeon asked why no one followed up on the blood sugars. We went to an endocrinologist that she sent us to. His A1c was only a 5.9. When he starts his seizures, that we caught his blood sugar, it was anywhere from 39 mg/dl [2.1 mmol/L] to 70 mg/dl [3.9 mmol/L] and some juice brought him right out of it.
We are waiting for a three hour test to be done. I have a really difficult time understanding the doctor as he is from India and has an accent. He says he thinks my grandson is in a honeymoon period, to feed him six times a day and watch his blood sugars. I don’t understand what a honeymoon stage is and I am scared for this little guy. He is on Lamectal, 75 mg, two times a day and has no problems. He has had a clear MRI and CAT scan. They think this might trigger the seizures. Is he saying he may be hypoglycemic or hyperglycemic? We do get a lot of high readings, including many in the 135 mg/dl [7.5 mmol/L] to 290 mg/dl [16.1 mmol/L] range during the day. Sometimes, he will go to bed with a 100 mg/dl [5.6 mmol/L] blood sugar and wake up with a 115 mg/dl [6.4 mmol/L] blood sugar. Sometimes, he will wake up wet and with a headache and it will be 60 mg/dl [3.3 mmol/L] to 70 mg/dl [3.9 mmol/L]. That’s when I give juice and a peanut butter cracker and he feels better right after that.
Last week he started to shake in school.When the teacher tested his blood sugar it was 40 mg/dl [2.2 mmol/L]. They gave him juice and a snack it came up to 145 mg/dl [8.1 mmol/L]. Ten minutes after that it went down to 107 mg/dl [5.9 mmol/L} and one hour later it was 90 mg/dl [5.0 mmol/L]. Any advice? What is Honeymoon period?
Answer:
It is very important that you understand exactly what your physicians are asking of you. If the physician has an accent, or you have difficulty understanding him, do not be embarrassed to ask him repeat himself, or have a follow up letter with written instructions and explanations, or ask to have follow up with the nurse who may not speak with the same accent.
From what you write, apparently your doctor suspects that your grandchild has diabetes and is in the “honeymoon phase” of diabetes. You should Search this website for the definition and the many, many questions that have already been asked about the diabetes “honeymoon.” In essence, the diabetes honeymoon is an early stage of diabetes whereby there is still some reasonable insulin production from the pancreas. During the honeymoon, glucose levels can fluctuate and low glucose levels are not uncommon if there has not been a good balance with meal planning, activiities, and insulin.
From your description, I am not convinced yet that your grandchild has diabetes, but I think it is reasonable to do a carefully performed several- hour glucose tolerance test. I would be more suspicious of low glucoses. Has the new neurologist done an EEG? CAT scans and MRI’s do NOT trigger seizures. Typically, one must have a pretty low sugar to trigger a seizure, unless there is also an underlying predisposition to seizures such as epilepsy or an anatomic concern seen on the imaging studies.
Please follow up with the physicians and be certain that your questions are understood and the answers are clear.
DS
