Hi
My little boy has had repeated vomiting episodes (although not loads and loads of them), plus abdominal pain and reflux so that he got referred to a paediatrician. They found nothing wrong with him. I've noticed though that the vomiting seems to happen a day after him not eating dinner the night before, and always dramatically improves after eating some carbs. Does this sound like ketotic hypoglycaemia? I'll take him to the doctor, however he's eaten now so I assume his blood sugar is normal. I suffer from some symptoms when my blood sugar is low but neither of us is diabetic.
Well, that is an interesting question as the most common time for blood sugar to drop is after NOT eating for a period of time. You are saying that you feed your child and AFTER that the blood sugar drops. That certainly is unusual, I'd say. What does your doctor say about this?
If the immune system attacks the pancreas, issues are seen. Has anyone talked to you about Type 1 diabetes? Are they watching your child for this? What about Fatty- acid metabolism disorder? This involves how a child metabolizes certain enzymes. Are they looking into some of these types of things?
They do have diabetes educators that can go over diet for hypoglycemia and I'd ask your doctor about this. Are you suppose to avoid refined sugar? They typically recommend frequent meals high in protein and carbohydrates.
But that certainly is confusing about when the testing shows blood sugar dropping. Keep us updated.
Ketotic hypoglycemia more commonly refers to a common but mysterious "disease" of recurrent hypoglycemic symptoms with ketosis in young children. The cause and the homogeneity of the condition remain uncertain,[1] but a characteristic presentation, precipitating factors, diagnostic test results, treatment, and natural history can be described. It remains one of the more common causes of hypoglycemia in the age range.
The typical patient with ketotic hypoglycemia is a young child between the ages of 10 months and 4 years. Episodes nearly always occur in the morning after an overnight fast, often one that is longer than usual. Symptoms include those of neuroglycopenia, ketosis, or both. The neuroglycopenic symptoms usually include lethargy and malaise, but may include unresponsiveness or seizures. The principal symptoms of ketosis are anorexia, abdominal discomfort, and nausea, sometimes progressing to vomiting.
If severe, parents usually take the child to a local emergency department, where blood is drawn. The glucose is usually found to be between 35 and 60 mg/dl (1.8-3.1 mMol/L). The total CO2 is usually somewhat low as well, (14-19 mMol/L is typical), and if urine is obtained, high levels of ketones are discovered. Ketones can also be measured in the blood at the bedside (Medisense glucometer). Other routine tests are normal. If given intravenous fluids with saline and dextrose, the child improves dramatically and is usually restored to normal health within a few hours.
A first episode is usually attributed to a viral infection or acute gastroenteritis. However, in most of these children one or more additional episodes recur over next few years and become immediately recognizable to the parents. In mild cases, carbohydrates and a few hours of sleep will be enough to end the symptoms.
Precipitating factors, conditions that trigger an episode, may include extended fasting (e.g., missing supper the night before), a low carbohydrate intake the previous day (e.g., a hot dog without a bun), or stress such as a viral infection. Most children affected by ketotic hypoglycemia have a slender build, many with a weight percentile below height percentile, though without other evidence of malnutrition. Overweight children are rarely affected.