My son, diagnosed two years ago, is well controlled well with A1cs around 6.8%. He passed out at school this week. He had convulsions, and his blood sugar at the time was 3.8 mmol/L [68 mg/dl]. This was the first time he passed out since diagnosis. He’s had a few readings that were lower but has never passed out before. I knew people passed out, but the convulsions took me by surprise even though the doctor says it can happen. Is this normal for a blood sugar reading of 3.8 mmol/L [68 mg/dl]? How is glucagon in the body produced? By the liver or pancreas?

My best guess is the 3.8 mmol/L [68 mg/dl] was on the way back up. Remember there are other hormones that raise the blood sugar (cortisol, epinephrine, glucagon, growth hormone. I have seen cases in which the child passed out and then awakened to discover he had been low. Spontaneous recovery isn’t uncommon.

Obviously, we should avoid this. Two years and 6.8% hemoglobin A1c means he likely has other low glucoses you don’t know about. Be vigilant and check during the night and other times when insulin could peak.

LD

[Editor’s comment: Glucagon is produced in the islets of the pancreas. The specific cells that make glucagon are called alpha cells.

SS]