Question from Lititz, Pennsylvania, USA:

My son is 22 months old. He was born seven weeks early, but with no major problems. Overall, he has been very healthy other than bilateral tubes in his ears for chronic ear infections. About five days ago, when my aunt was watching him he woke up from a nap acting very strangely. She said that he was very shaky, irritable, crying and was acting as if he was dreaming with his eyes open. Then, about three days ago, he was in his own bed and woke from a nap and acted oddly again. I went to get him and he didn’t want me to pick him up, stiffened his body and was shaky, sweaty and crying. Finally, this morning he woke up about two hours later than normal and was still very lethargic. He did not want to get up and after about a half hour I put him on the ground to go downstairs. He flopped down and shut his eyes. Then, he was very shaky, sweaty and crying again. I thought he was acting like his blood sugar was low, so I gave him orange juice. He felt better a few minutes later and was fine for about 20 minutes. He then vomited profusely and was very pale. I took him to the doctor’s right away and they checked his blood sugar, which was 59 mg/dl [3.3 mmol/L]. He was also dehydrated. What could this mean? Could he be diabetic or hypoglycemic?