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September 30, 2007

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Question from North Kingstown, Rhode Island, USA:

My son has been having early morning seizures when his blood sugars are between 150 mg/dl [8.3 mmol/L] and 200 mg/dl [11.1 mmol/L], very normal numbers. The doctors cannot determine a reason, and say although not hypoglycemic, they are diabetes related. Have you ever heard of this?

Answer:

I am not certain what is meant by “although the seizures not hypoglycemic, they are diabetes related.”

Very commonly, ANY seizure, (related to idiopathic epilepsy, for example), is more likely to occur just before awakening and just when falling asleep. Our “threshold” to having a seizure is commonly lowest at those times. Many metabolic disturbances, including hypoglycemia, can lower the threshold to having a seizure (at any time of the day).

If your child’s glucose levels are TRULY not low, as you describe (I assume you have checked the meter for coding and accuracy), then I would be very hard pressed to ascribe the seizures as being “diabetes related.” A possibility does come to mind: perhaps he experiences a very rapid falling of his blood glucose in the time before awakening. Then, it might not be the absolute glucose value, but how fast it is going down. A continuous glucose sensor could help clear this up.

I think the child should be seen by a pediatric neurologist and evaluated for a concurrent seizure disorder, if this had not already been done.

DS