Worried about hypoglycemic son!

[Joy H.]

Hello, I just wanted to know if anyone can offer any comments. My son is 6 and he started showing symptoms of hypoglycemia 2yrs. ago. It started out with him getting very pale, shaky, and he would start vomitting. I bought a glucose meter to keep at home so I could check his sugar when the symptoms started to appear. He has had readings down to 40mg/dl. I can give him a coke or something sweet and within 15min. he will start to feel better and the symptoms will go away. He was hospitalized a year ago for vomitting and dehydration and he had a glucose reading of 43mg/dl. I had told the doctors about the episodes he had at home, but they did not seem worried about it. Just last week he had another episode that landed him in the hospital. He had a glucose level of 50mg/dl, but this time when they tested his urine he tested positive for ketones and reducing substances. Since diabetes runs in both sides of the family, I can't help but worry. Could this be a sign of diabetes or could it just be from dehydration? He does have an appt. with a Pediatric Endocrinologist next month, but I would like to have an idea of what might be going on. Everything I research keeps coming up on diabetes. I would appreciate any feedback on this matter.

[JDRF-Team-LRS]

Hello Joy,
I'm a volunteer and not a physician, so do continue working with the docs on this.

A number of folks with diabetes did start out with episodes of hypoglycemia during the years before their diagnosis.  Not all of us started out that way, but some do.

The ketones in his urine can be an indicator that he's metabolizing fat because his cells can't get (enough) glucose.   That can happen during extreme exercise and with soem weight loss.  It is crucially important to ensure he gets plenty of fluids and that his electrolytes are well-balanced also.

One of the tough things about hypoglycemia (different from diabetes), as I understand it, is that the pancreas secretes too much insulin in response to high carbo foods.  Thus treating the low may trigger another cycle.  Some folks manage lifelong hypoglycemia with frequent small meals & snacks (ideal for a growing boy!) and with a focus on "complex" carbohydrates rather than simple carbos.  You're right that a low must be treated with simple carbos.  15 gms of glucose is what we diabetics are taught to start with.  Test again in 20 minutes & treat again if needed.

While I'm not a physician or a nutritionist, I would recommend that you keep very careful notes of what your son is eating & drinking along with careful notes on his activity levels/lethargy and how he feels.  That info, coupled with the the periodic blood tests & urine tests will help convey the whole story to your doc.

Between now & your appointment, however, discuss with your doc some decision rules -- how much ketones and for how long; how much vomiting & dehydration and for how long ... should be a trigger for you to bring him to the ER?  Ketones in urine signals a problem; left to continue, it can lead to a buildup in the bloodstream -- a much more serious, dangerous situation.

Your son is so lucky that you're alert to these issues already.  I wish you well.

[Pitzi]

He needs to see a specialist ASAP. I think his insulin dosage or type is incorrect

[JDRF Team SGG]

I believe the last responder made an incorrect assumption that this boy is a diabetic. Not so, according to what the parent has written. So the boy cannot adjust insulin dosage if he is not on insulin. The hypoglycemia is happening to a boy who has NOT been diagnosed as being diabetic. So diet is about the only way to try to help him. As LRS wrote, a diet which includes complex carbohydrates rather than simple sugars and frequent snacks may help prevent this. Many people who have hypoglycemic problems seem to do best when they eat proteins as snacks with small amounts of complex carbohydrates,

[handsome]

Hmm..

Interesting. What is syndrome called?