March 4, 2006
Diagnosis and Symptoms, Hypoglycemia
Question from Ann Arbor, Michigan, USA:
My four year old son has episodes where he becomes combative, crying for no reason, uncontrollable, etc., all the signs of hypoglycemia.
We took him to the doctor in April, when he was three years old, and the symptoms were at a high point. We were told that toddlers frequently go through a stage of hypoglycemia due to the amount of running around they do. But, we were told to feed him every two hours, decrease his intake of sugar (which was not much to begin with), and watch him.
Last week, we took him for his four year old check up and mentioned that it has not gotten any better. If he falls asleep after school and wakes up or we have a late lunch/dinner, he has episodes, but, if we get him to eat or has a piece of hard candy, he is fine within five minutes. Once again, we were told that this is a phase, to feed him every two hours and watch him. Only when he has a seizure or passes out will the diagnose him with hypoglycemia. The doctor said his sugars are “sensitive.”
My mother and grandmother, and my son’s paternal grandmother are all are insulin dependant diabetics. So, we know very well the signs and symptoms.
How do we get this child diagnosed? Does he really have to have a severe episode and pass out or seize before they will do anything?
If we do not officially get him diagnosed, we are afraid that when he hits kindergarten or first grade, they will not allow him to eat every two hours as directed by the doctor, and he will have an episode at school. My friend is the principal and has said that without a diagnosis of hypoglycemia, they cannot just allow him to eat every two hours for “sensitive sugars”.
What do you suggest we do? I am very concerned about my son.
Answer:
First of all, the principal is incorrect. If you and your pediatrician believe that your son should eat every two hours and avoid sugars, the schools (public schools, that is) all over the United States must follow this medical advice. You, as parents, simply insist and request that an individualize educational plan, in this case a medical problem, be created. As parents, you must be allowed to sign off on this plan and the public school officials must carry it out. It’s the law!
As far as diagnosis, it may be wise to learn how to check finger stick blood glucose levels and run what we call a profile, just before eating and one to two hours after eating, plus anytime you notice any unusual symptoms – during illness, when there has been a lot of activity, when the food plan is not being followed for any reason. This will allow you to see rather quickly if there are normal or abnormal blood glucose readings. Doing this for a few weeks will answer such questions for you.
Frequently, even without documented blood glucose levels that are hypoglycemia (less than 60 mg/dl [3.3 mmol/L]), many people, including children, feel better avoiding simple sugars and making sure that there is always some fat/protein with food and snacks. Peanut butter works as do eggs, meats, and cheese. You’ll learn what works by being a good detective and keeping good and detailed food records, plus the blood glucose readings.
There are also some more rare metabolic problems. Some states screen for them in the newborn period. You may want to consult with a metabolic specialist or endocrinologist if there are still questions left unanswered.
SB
