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Question:

From California, USA:

I was diagnosed with hypoglycemia back when I was nine years old after a five hour glucose tolerance test. I am 39 years old now. I have four children and with my last pregnancy I experienced insulin-dependent gestational diabetes. My question relates back to the beginning when I was first diagnosed with hypoglycemia at the age of nine. I would experience the sensation you feel right before vomiting, I would run to the school bathroom and not be sick. But two different times I experienced a situation where my jaw would "freeze." I would be unable to speak for about 15 minutes. Eventually my jaw would "loosen" up and I would go from a garbled speech to my normal self. As I got older in the teen years I would just pass out. Have you ever known anyone with the jaw "freezing" problem? I have asked many doctors, but they never were able to give me an answer. Also, given my history and the fact that my father is a diabetic, what do you think my chances of eventually developing diabetes are?

Answer:

Hypoglycemia is a very unusual way for diabetes to present in a nine year old child, although it is not uncommon in young adults. Also if you have not developed insulin dependence after an episode of gestational diabetes and are now 39 years old you are rather unlikely to get Type 1 diabetes though a few cases are still reported in the early 40's. If that is what your father has the chances are only around 5% anyhow. You might consider talking to your doctor about getting an antibody test done; but I don't really think it is indicated.

If, on the other hand, your father is regarded as a Type 2 diabetic, it is a good deal harder to say what, if any, genetic predisposition he has passed on to you. It is true of course specific genetic conditions are being increasingly recognised. However exact diagnosis is difficult to get done and expensive and besides the treatment of these variants is usually much the same as it is for the generality of Type 2 patients. Most of these genetically defined variants either show a very strong family history or have conspicuous other symptoms and signs. In short, I think that your chances of getting diabetes are now those of the population as a whole, perhaps slightly enhanced by your brush with gestational insulin insufficiency.

As to your second question about your jaw 'freezing,' I have not encountered it; but it does not surprise me. The central nervous system is of course very dependent on a supply of glucose for metabolism which is why loss of consciousness and seizures are common features of severe hypoglycemia. The peripheral nerves are less susceptible; but monoplegias [single nerve deficits], difficulty in swallowing, and abnormal sensations are all recognised. As always, the best treatment of hypoglycemia is to avoid it and as control has been gradually improving these problems are seen less and less.

DO'B

Original posting 9 Nov 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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