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November 13, 2002

Hypoglycemia

Question from Wrentham, Massachusetts, USA:

My seven year old son, diagnosed and doing well with his diabetes for a little over two years, was diagnosed with asymptomatic celiac disease which we are treating with strict gluten free diet. Lately, I have noticed a strange phenomenon with his hypoglycemic episodes.When he feels low, I will test him and he will be in the 70s mg/dl [3.9 mmol/L], so I give him a small juice box or three glucose tablets, and when I retest in 15 minutes he is 40 mg/dl [2.2 mmol/L] or lower. I end up treating him two or three times with juice or tablets before I am able to get him above 70 mg/dl [3.9 mmol/L]. This can take up to an hour at which time I can finally give him a snack. During these episodes he is very scared, and, to be honest so am I.This has happened on at least five occasions in the past few months. The times vary and have no relation to activity as sometimes they have been in the middle of the night. Do you think he has some type of absorption problem aside from the Celiac that I may be missing? His thyroid tests are normal, and his hemoglobin A1css have remained in the 7.0-7.2% range for the two years. This is distressing, and I would like any input you could provide.

Answer:

I doubt that the trouble your son is having is related to his celiac disease. I suspect that the trouble you’re having may improve if you increase the amount of glucose you’re using to treat his lows. You might try using 25-30 grams of carbohydrate rather than just 15. For more information and tips on treating lows, please see hypoglycemia.

MSB