December 27, 2007
Hypoglycemia
Question from Bath, Maine, USA:
My 10-year-old son has type 1 diabetes. This past spring, he had three blood sugar levels in the 300s mg/dl [over 16.7 mmol/L] but, since then, he has been in a honeymoon period with blood sugar levels no higher than 170 mg/dl [9.4 mmol/L]. He is not on insulin. We test him often because he is having lows now. He is shaky and tired often and the levels have been in low 80s mg/dl [4.4 to 4.6 mmol/L] and low 70s mg/dl [3.9 to 4.1 mmol/L]. One morning, he woke up and his blood sugar was 51 mg/dl [2.8 mmol/L]. He could barely move. He is falling asleep in school. He also has ADD and takes Concerta, 36 mg daily. Before the diabetes, he barely slept. I feel like I do so much reading in trying to understand his situation but am not finding why he is having lower blood sugars when most people are not like this. Could he have something else? Or, am I not understanding what is happening? His grandfather has type 2, his great grandmother had type 1, and about four great aunts and uncles have type 1 or type 2.
Answer:
You should go back to your diabetes team and ask if they have checked antibody levels. This would help to determine if this is type 1 diabetes or not. There are other types of diabetes that are more rare, called MODY, that occur in non-obese children. Treatment is different than type 1 diabetes. If he continues to have hypoglycemia, then you should also call the diabetes team and let them know so that they can help problem solve with you and see what is the cause. Sometimes the pancreas mis-fires and overshoots insulin particularly in its early phase of demise. Close glucose monitoring and strict meal planning, timing and amounts of foods/snacks almost always stops such problems.
SB
