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Question:

From Monterey, California, USA:

I am a 28 year old woman with a serious family history of diabetes (both parents, 3 out of 4 grandparents). I have been feeling extremely sick mid-morning and mid-afternoon, dizzy, light-headed, unable to concentrate, emotionally unstable. I always thought it was all in my head. But after my mother's recent diagnosis she suggested using her monitor to test my blood sugar, thinking it might be too high. Two hours after lunch it was 47. So at the suggestion of my Godmother, a dietitian and diabetic, I attempted a 12 hour fast, and it read at 48. Since then I have been following the suggestions she gives for hypoglycemics and have been taking it several times a day (for 4 days, gathering data for a doctor visit soon) and it has never gone above 80. Do I have simple hypoglycemia, or perhaps something else?

Answer:

The problems you describe are not new: a possible diagnosis of intermittent hypoglycemia with a strong family history of diabetes.

The diagnosis of hypoglycemia is based upon:

  1. appropriate symptoms (partially from brain malfunction, including headache, hunger, and inability to concentrate) and partially from release of counterregulatory hormones such as epinephrine, which cause shakiness, sweating, and rapid heart rate),

  2. documented low blood sugar levels, and

  3. appropriate response to appropriate treatment (food containing carbohydrate should result in improvement within an hour at the very longest).

I have seen many patients who suspected that they have hypoglycemia; sometimes they have a strong family history of diabetes and have definite improvement by starting a diabetic-style meal plan. I encourage such patients to talk to a dietitian who's knowledgeable about diabetes, and to monitor their sugar levels occasionally so they know where they are at. I have seen several such patients who later progress to full-fledged hyperglycemia (diabetes) after several years of bouncing around on the low side.

As you indicate, it's sometimes difficult to differentiate between the possibilities of psychologic problems versus unstable blood sugars which you seem to have inherited from somewhere. But it's very unlikely that your situation represents anything else than one of these possibilities, and it's no harm to place you on a diabetic meal plan in either case.

WWQ

Additional comments from Linda Mackowiak, diabetes nurse specialist:

In addition, I would add that a home meter cannot accurately distinguish between a "normal" and a "low" blood glucose level. You would need to contact a doctor, and have your blood analyzed in a laboratory (in the appropriate tube to prevent the blood glucose from dropping as the blood sits).

LM

Original posting 15 Jul 1998
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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