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October 24, 2000

Hypoglycemia

Question from San Mateo, California, USA:

My seven year old daughter has been having "episodes" (I use this term for lack of a better one) of hypoglycemia attacks for the past four years. Her brothers, now 14 and 16, had the exact same symptoms when they were young, but they grew out of them or learned to control it. Although never officially diagnosed as hypoglycemia, we feel it is inherited from my husband's family as he and his sister had similar symptoms growing up. A brief summary of an episode: she will wake-up lethargic and feel like she has to throw-up. Her heart rate is fast and she has hand tremors. She will vomit for a few hours, sleep on and off. Then, after three to four hours, she will go into a deep sleep for around an hour and wake up perfectly fine. I have read about nighttime hypoglycemia (as these episodes only happen in the morning) somewhere, but can't seem to find the article again. I have been able to control this by giving her cereal before bedtime. Our problem is that she is a very finicky eater and will not eat if she is too busy. This is a constant battle. Her pediatrician is recommending that she be tested in the endocrine department of the children's hospital, even though she just had an entire round of blood and urine tests in a fasting state and everything showed up normal. I'm assuming I'm on the right track. I am just looking for some information on nighttime hypoglycemia.

Answer:

Despite your husband’s family history, this is not hypoglycemia until it is proven in the lab. The endocrinology unit may indeed be your best option to determine if blood sugar is playing any role in your daughter’s symptoms. With the advent of The Continuous Glucose Monitoring System, your daughter can wear a small monitor on her belt connected to a sensor that is easily put into the skin of her abdomen and almost 900 sugar readings can be obtained over a three-day period. This is the best option available to you now to help determine if these events are caused by low blood sugar. All too often, “hypoglycemia” in families is a diagnosis passed down from family members with no substantive evidence of a real blood sugar problem. Please visit with your pediatrician and see if he would recommend visiting an endocrinologist for the testing I’ve mentioned above.

MSB