January 23, 2007
Hypoglycemia
Question from Bradenton Beach, Florida, USA:
We just moved here from Texas and don’t yet have a doctor. I was not really happy with my doctor’s answer in Texas, although he did suggest a diabetic diet. My concern with my son started when he was around one. We don’t eat much sugar or dessert in our house. The first time I noticed a problem was the day after my son’s first birthday party. He ate cake for the first time in the evening, then threw up the next morning. Later, when my mom fed him iced cookies or Pop Tarts, he threw up as well. After he got candy in Sunday School at age one, my normally well-behaved child got extremely hyper and had an emotional meltdown. I had to leave restaurants on two occasions. I gave him four ounces of orange juice for the first time at age two and he literally climbed on the kitchen table and jumped off. At that point, I took him to the doctor who tested his blood sugar and found it slightly low, but in normal range. He suggested a “diabetic diet.” We cut out all sugars and juice and gave him frequent protein snacks. We still follow this diet. We notice problems, however, when caregivers can’t get him to eat his protein or when they violate and give him sweets. Our daycare director in Texas eventually confirmed what we saw and noticed the difference if they “messed up.”
About a month ago, we tried to see if he could tolerate juice. We gave him an apple juice box from McDonald’s. He got very hyper for about 20 minutes, then had an emotional meltdown. He complained of his tummy hurting. His temperature dropped, then he fell asleep.
Now, he is in a new daycare. I am frustrated with people not taking his diet seriously and the same people label him as wild.”Sugar sensitive” does not seem to be a big deal to them. I have tested his blood sugar twice. Both were fine. I have not done a test during an episode.
I have low blood sugar tendencies, but have not been diagnosed. I just eat a lot and watch my carbohydrate intake. My brother was diagnosed with hypoglycemia (not sure which kind) when he was three.
Can you help? What do you think he has?
Answer:
This could be a form of what is called reactive hypoglycemia. Your doctor was correct in treatment with a “diabetic diet,” although, more properly, it would be described as restricted simple carbohydrates (sugar, candy, juice, fruits sometimes also potatoes and other simple starches) and always making sure that he has some protein and fat PLUS never going past about three hours between such meals/snacks. This avoids the excessive insulin release from the pancreas when sugar is introduced alone and, therefore, avoids the insulin produced hypoglycemic effect. The sugar rush you are describing probably is not a real phenomenon, but the late hypoglycemia is. You can get a glucose monitor and check his blood glucose levels at 30 to 60 minutes after food or sugar and see how high the rise is, then do the same when there are symptoms or if food with protein/fat is not provided every three to four hours, and see if there is documentable hypoglycemia. Hypoglycemia is defined as blood glucose less than 60 mg/dl [3.3 mmol/L] WITH symptoms (shaky, sweaty, pale, rapid heart, etc.). There are other more rare kinds of serious hypoglycemia, but these would be diagnosed only if the dietary treatment does not work.
SB
