Type 1 or hypoglycemia?

[merrymom]

My 6 year old daughter had an "episode" about a month ago with sudden nausea, shakiness, sweating, pale color.  It passed in about 10 min.  Since then, she is just "not right".  She still has these "episodes" every couple of days, and often (3-5x/day) has "an icky feeling", sometimes intense hunger then feels nauseous when food is presented, decreased appetite, overall pale color with dark circles under her eyes, and sig. decreased energy/fatigue. Her pcp did stool samples (-), a U/a (-), and bloodwork (normal except slightly inc. SED rate-23).  He referred to GI who rec. Prevacid 15 mg 2x/day and follow-up in 2 months.  He said ulcer can't be r/o w/o scope which he will do if not better, but that Prevacid should help.

My instincts tell me it's not a GI thing.  I asked about low blood sugar since snacking sometimes helps.  Both drs said hypoglycemia is over-dx'd and treated, and didn't think this was her issue.  Diabetes does run in the family.  I think GI isn't looking at her whole picture. Also, she has never been an anxious child, but there definitely is a psych. component now (behavior, moodiness, glum).  I wonder if that is a result of  feeling sick, not vice versa.  Please help!  Thanks.

[JDRF Team SGG]

The symptoms you describe sound suspiciously like hypoglycemia, including the slight nausea when the episode is present. Moodiness can be a symptom of hypoglycemia, too, for some depression can set in just when glucose levels are low. Some doctors truly don't "BELIEVE" in hypoglycemia, and if I were in your shoes I would try another doctor until you find one who does treat for hypoglycemia. This can be hard to prove with blood tests sinceit is a temporary thing, and you cannot produce a hypoglycemic episode necessarily just when blood is being drawn.

You may want to work some small changes to her diet -- avoid simple sugars, for "reactive" hypoglycemics, those whose pancreases are overstimulated by sugary foods, will suffer lows after eating foods high in simple sugars. Complex carbohydrates are not as likely to stimulate insulin production. Also, make sure that she eats some sort of protein with her carbs since protein slows down the absorption of the carbohydrates. She may do well to nibble on small snacks about halfway in between regular meals, too, just to keep some food in her system.

[JDRF-Team-gg]

Dear Merrymom,

I am the mom of a 17 year old who was diagnosed at the age of 21 months.  I am not a medical professional, so any information obtained should be verified with your daughter's healthcare team.  

Looking back on my daughter's diagnosis, I now wish that I had asserted myself more.  She also had the same tests performed that your daughter has had done.  Only when I "lost it" with the primary care physician, did blood work get done and diabetes diagnosed (her blood glucose was 910 & the target range is typically 80-120).  I am not familiar with the SED rate you mentioned (sorry) so I cannot comment on that.

You know your child better than anyone and if you are not satisfied with the care she is receiving, and you believe that there's something else at the bottom of her physicial state, you go and find someone who will listen to you and help her to get back to feeling normal ASAP.  You mention that diabetes does run in the family, so if you have access to a blood glucose monitor, you may want to check her bg level yourself.  You can also purchase urine test strips that indicate sugar levels, however they are several hours old, and also if ketones are present in the urine. If she is showing ketones, this is extremely urgent and you should seek immediate medical attention.

Most importantly, seek out an endocrinologist, (a diabetes specialist) to have your daughter evaluated immediately.  I know it's the week-end, but don't hesitate another day. You need to go with your gut & motherly instinct on this one.

Please post again to let us know how you make out.