January 25, 2001
Question from Campton, Kentucky, USA:
My two year old son who has hypoglycemia woke up screaming and semi-conscious with his blood glucose at 30 mg/dl [1.7 mmol/L]! Can a hypoglycemic person have a high sugar reading? Is it true that a hypoglycemic person cannot go into a coma from low blood sugars? My son's primary care physician tells me not to worry because the the only way he would go into a coma is if he had diabetes and was receiving insulin. Why isn't there danger of his slipping off into a coma if his blood sugar is lower than 30 mg/dl [1.7 mmol/L]? I feel like I am getting a lot of bad advice. I am taking him to see a pediatric endocrinologist. Just by talking to them on the phone, I feel like they might actually know something. They feel that this is definitely not normal whereas his primary care physician says there is nothing wrong.
I am assuming that your son does not have diabetes, but has symptoms suggestive of hypoglycaemia not related to diabetes. If this is the case, it is unusual for a child with hypoglycaemia to have high readings, but I suppose this can happen on occasion as a rebound response of the body to hypoglycaemia. It does depend on the cause of the hypoglycaemia, and if your son is dropping as low as 30 mg/dl [1.7 mmol/L]. It is not normal for a child to have a blood sugar reading as low as this.
It is important to have him seen by an expert to determine the cause. It may be that he will need to see a specialist in metabolic medicine, but the paediatric endocrinologist should be able to sort things out.
[Editor’s comment: You are doing exactly the thing by taking your son to seen a specialist. Children this age in particular can develop serious brain damage from consistent hypoglycemia. There are a number of enzyme deficiencies, etc, that can cause this, as definable, and can be treated. Please see SS]