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December 3, 2002

Diagnosis and Symptoms, Hypoglycemia

Question from Hollidaysburg, Pennsylvania, USA:

Last week, my four year old son woke up a little pale and extremely tired which is unusual for him. ((He is the type who always wakes up with energy and goes straight to the TV to watch cartoons while I make breakfast). However, this morning, he did not want to eat and did not turn on the TV. I just figured he was coming down with the flu or something and shrugged it off at first. I let him go back to sleep while I ran to a doctor's appointment and left him with his grandmother. While I was gone, his grandmother checked on him every 10 minutes because of how he had been acting when he first got up, and, when I returned home, I found to her looking at my son saying he looked paler than 10 minutes previously. She was in shock too. (This is a boy who, even when sick, still is full of energy and refuses to nap etc., and I was only gone 45 minutes.) I could not believe my eyes, he was paler, listless, and I had a difficult time waking him. I had brought him a toy that he had asked for the day before, but, even after I had him awake, he pushed it away which was also odd. I called the doctor who told me to take my son to the ER right away, which I did, and on the way into the ER, my son told me his legs felt like jelly.. After sitting in the ER for a while, my son started to say things that did not make sense. The ER nurse and doctor knew my family, could not believe that was my son lying there, and did blood work right way. (They know this is the same kid I have to tell 20 times to sit still.) My son had no other symptoms except the paleness and being very hard to keep awake. My son woke up for a few minutes asking for some applesauce and the nurse got some. Within 10 minutes of eating the applesauce and drinking 20 ounces of a sports drink, my son was starting to act normal -- laughing and wanting cartoons on the TV in the ER etc. I have low blood sugar myself, but I never get those symptoms, only talking odd and feeling lightheaded or headache etc, so I started to wonder about his blood sugar level. I asked the nurse if a blood sugar level was ordered prior to his eating, they had, and it was 52 mg/dl [2.9 mmol/L]. He also had a WBC of 18, 000, but they had no explanation for what happened. They kept us for a few more hours and then sent us home knowing that I had a glucose monitor at home to check his levels. Needless to say, I did not sleep that night keeping an eye on him. At 7:00 am the next morning, we reported back to the ER for more blood work. His WBC was 9,600 and his sugar level was 91 mg/dl [5.1 mmol/L]. There were no explanations given for what happened or why. They said perhaps the WBC went up because his sugar level went down, but they had never heard of this. My son's pediatrician just said that he didn't eat, but my son had eaten a snack right before going to bed the night before. My son is still pale (but not as pale as that morning), and he is back to his normal self. I have been testing his blood sugar levels on my own, at bedtime and upon waking, and I am keeping a diary of them type�2 diabetes runs in my son's father's family and in mine. Have you heard of this? Should I be checking his sugar certain times of day? Do you feel I should make an appointment with a pediatric endocrinologist?


I would suggest that you make an appointment with your pediatrician to discuss the events and your concerns.


[Editor’s comment: I suggest that you continue to continue to monitor, as you have been doing. In addition, you should watch for symptoms of hypoglycemia, check a blood sugar if you see them, and report findings to your son’s doctor. Should this continue, and/or you are uncomfortable with what you are being told, you can most certainly ask for a referral to a pediatric endocrinologist.