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March 9, 2001

Hypoglycemia

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Question from Lake in the Hills, Illinois, USA:

Our 16 month old daughter was diagnosed with diabetes about six weeks ago, and has had four seizures during sleep, which of course, wake her up. Three of the seizures have been with a blood sugar of 32-39 mg/dl [1.8-2.2 mmol/L]. Her last one was with a blood sugar of 80 mg/dl [4.4 mmol/L]. She has been as low as 32 mg/dl [1.8 mmol/L] during the day, but you would not even know she was low. Is there a reason why they may be happening while she sleeps? Her doctor explained that the seizure when her blood sugar was 80 mg/dl [4.4 mmol/L] may have be due to her now producing insulin (the honeymoon). It just does not make sense to us.

Answer:

From: DTeam Staff

You need to work closely with your diabetes team to prevent nocturnal hypoglycemia. It sounds like there are too many hypoglycemic episodes overnight. Some very young infants need diluted cloudy insulin as a bedtime (11 pm) dose to prevent this. Also, we have had some success using ice cream as a bedtime snack since the extra fat in the ice cream makes the energy last longer over the night. We also would adjust the insulin to not peak in the middle of the night.

Has an EEG been ordered? If abnormal, this might indicate the need for antiseizure medication to try to prevent the seizures.

SB