ketonic hypoglycemia

[jamsmom]

Hi, last saturday my 28 month old son would not wake up. I tried various types of physical stimulation to wake him but they did not work.My husband would bounce him in his arms and he would wake up a little but when he stopped his head would roll and he would close his eyes again. We put him in the car and took him to the E.R.
On the way there i could get him to wake up a little and drink some soda. In the 15 mins it took to drive to the E.R. he woke up and was acting normal. They took a glucose test at the hospital and it was 130 (after drinking 8 oz of soda)and sent him home. The next day we took him to his pediatrician and had a fasting glucose test which had the result of 85. The pediatrician gave us the result of ketonic hypoglycemia. Is there a special diet i need to put him on? How often  would he have episodes? And could he have had a one time only episode?

[LovieL]

my two year old son was just diagnosed with ketonic hypoglycemia and our endocrinologist and geneticist are having us put cornstarch in a drink or applesauce before he goes to bed to help his sugars last all night long so his body does not go into a fasting state.  He has had four glycemic spells and each has gotten worse.  we almost lost him this last time and needed some answer.  ask your doctor about this.

[JDRF-VOL-SG]

We have heard of a few other situations like this with small children, and I know it must be terrifying for the parents. From what I have read about hypoglycemia, different people seem to have different types of hypoglycemia, meaning that different things bring on episodes. For some people, hypoglycemia happens if they don't eat enough carbs at one meal or if they skip a meal. For others, too many carbs, mostly high-glycemic index carbs, can stimulate the body to produce too much insulin and results in a hypoglycemic episode in later hours. It might do you well to try to remember what he ate the day before, especially the evening meal or bedtime snack if there was one. Was it a high-carb meal or low-carb meal or snack?

The common-sense approach would be to rationalize thus:

If he didn't eat much the night before, picked at his food, or was just too tired to eat, then he may be a child who needs to eat some carbs before he goes to bed. It could be that he just went too long without food and his body needed those carbs in order to have enough energy to wake up.

If, on the other hand, he ate lots of foods with a high glycemic index before he went to bed, such as sweet juices, pizza, fries, etc., then what may have happened was more of a reaction to those foods and he may be a child who needs a diet more focused on low-glycemic-index foods.

Here is a website that might provide more info for you: www.hypoglycemia.org

This is not a predictable thing... let's hope it never happens again. You would do well to keep juice available in case it does. Symptoms of hypoglycemia to watch for in small children who aren't verbal enough to tell you if they feel woozy are:
  irritability or unexpected tears
  sleepiness
  chills, followed by breaking out in a sweat
  yawning for no apparent reason (a toddler I babysat would do this if his
     glucose was dropping... the brain needs glucose for energy and if glucose  
     is low, sends for oxygen)

Sometimes the child craves food, but sometimes low blood sugar will make a person feel slightly nauseated and food is the last thing they want.

Although I am a type 1 diabetic, my own daughter is not. She is now a young adult, and her blood sugar is fine. However, she is a person who cannot skip meals without feeling crummy and getting a little hypoglycemic. This has nothing to do with what her diet is, but more to do with needing to be regular with food intake. I had a sister-in-law, on the other hand, who was a classic reactive hypoglycemic. If she ate desserts or big meals with lots of carbs, she would get so sleepy that she would just sleep through after dinner conversations. I remember one time when she couldn't resist a big chocolate chip cookie at a beach gathering, fell asleep in a folding lounge chair and we just couldn't wake her up at all.

One thing to comfort you: type 1 people who become hypoglycemic are in a life-threatening situation because our brains can't tell our bodies to stop producing insulin. But non-diabetic people are not in as dire of a situation, for most people will self-correct in time. Normal people's brains will tell their livers to dump emergency sugars which will raise those low glucose levels on their own, but it takes some time for this to happen. And of course, there are exceptions to the rule. Many people become hypo after a large meal and get a case of sleepies, but their bodies fix the low within a few hours. Perhaps your little one would have self-corrected in time, but you were wise to take him to a hospital. Let's hope this was a one-time situation, and your child never does this again.