My teenager had a blood sugar of 57 mg/dl [3.2 mmol/L] and was diagnosed with hypoglycemia in the emergency room. Could this have been a one time fluke? Should I have him tested more extensively now?

A blood glucose of 57 mg/dl [3.2 mmol/L] is low-normal. You should discuss this with your teen’s primary care provider, and if there is still some doubt, seek a pediatric endocrinology referral. The key is to document blood glucose levels frequently and, if they are really less than 60 mg/dl [mmol/L] with symptoms at the same time, get a simultaneous insulin, cortisol and growth hormone level to try to decide what is the possible cause. Often, all these values are normal and merely eating in a healthy fashion with 3 meals and 3 snacks containing protein stops the problem. However, go discuss this with your son’s doctor, and perhaps an endocrinologist to be sure.

SB