December 27, 2007
Hypoglycemia, Pills for Diabetes
Question from Madisonville, Tennessee, USA:
We just found out our 10-year-old daughter is insulin resistant, but her fasting blood sugars were 80 mg/dl [4.4 mmol/L]. She was put on metformin and that’s all they told me. She has been on the medication all week but, today, had an episode with her blood sugar. She was nauseated, had a headache, and felt shaky. They tested her sugar in the school clinic it was 75 mg/dl [4.2 mmol/L]. They gave her a 23 grams of carbohydrates snack, waited 15 minutes, tested her again and her blood sugar was 30 mg/dl [1.7 mmol/L]. They gave her peanut butter crackers and juice, waited, tested her again and her blood sugar was 85 mg/dl [4.7 mmol/L]. I called her pediatrician and they told me to call them back if she has another episode. I can’t get her to see an endocrinologist until April. What should I do?
Answer:
She needs a diabetologist and not a pediatrician. The treatment of hypoglycemia is not with high fat foods, but with simple, fast acting sugars. So, likely the first treatment did not work because the fat slowed down the absorption of the treatment itself. And, the shakiness may not have been a hypoglycemic event at all since there was no hypoglycemia that time (hypoglycemia being a blood sugar less than 60 mg/dl [3.3 mmol/L], in general). She may have been feeling the sugar levels dropping. It is fairly rare for metformin to produce hypoglycemia so I would urge you to see the diabetes specialists, figure out the appropriate diagnosis and treatment including what needs to be done with food, snacks, activity, monitoring, etc.
SB
