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Question:

From Wausau, Wisconsin, USA:

My three year old son was diagnosed with ketotic hypoglycemia at the age of 17 months. He has had several tests done in the last year because of unusual blood sugar readings.(highs and lows). I'm not sure of all of the tests, but I can tell you that his islet cell antibody test was negative, and his hemoglobin A1c has gone from 5.9% last year to 5.0% last month. A couple of weeks ago, he had a fasting blood glucose of 62 mg/dl [3.4 mmol/L], and that same morning his cortisol level was a 9.0. I have been told that his growth hormone was on the low end of normal in the past, but he seems to be growing at a somewhat steady pace over the last year anyway.

The problem I am seeing in my son is that he is sick or sickly all of the time. I realize that the tests he's had done indicate that he does not have diabetes (although we do have diabetes in the family -- my brother died at the age of 26 from complications of it). I am okay with that thought process, but I just don't understand why he is so sick all of the time.

My son also continues to have blood sugar readings that go above 200 mg/dl [11.1 mmol/L] once in a while, but they come back down without the use of insulin. His lowest reading was 35 mg/dl [1.9 mmol/L], and he presented with ketosis at that time as well. He was also hospitalized with foot and mouth disease late last year with a reading of 40 mg/dl [2.3 mmol/L] when I couldn't wake him. They put a glucose IV in him to keep him hydrated, and it took about 22 hours before he woke up from that low.

His pediatric endocrinologist has suggested that at times hypoglycemia presents itself before diabetes, and that perhaps my son may not have ketotic hypoglycemia. However, they are not changing the diagnosis at this time until something more surfaces.

So for now, my concern is that my son seems to "catch" everything since he was first diagnosed with hypoglycemia last year. Sickness just seems to hang on and not let go. He has also had diarrhea off and on for the last month and a half or more and vomiting at least once almost daily. He has no fever and seems to be playing just fine through all of these symptoms.

His pediatrician has drawn blood to check his immunoglobulin, level, but I don't know what he is wanting to do (if anything) once we know those results. I would appreciate any thoughts on this as I am very concerned about my son's health.

Answer:

I am not able to make a new or unified diagnosis. Ketotic hypoglycemia does exist and children tend to outgrow it over time. Children, especially young children, do "catch" a lot of infectious diseases per year, and more when exposed in day care or other situations.

I agree there aren't data presented to support diabetes now. I would ask a few fundamental questions -- Is he growing normally, developing normally and gaining weight normally? If yes, all might be okay.

LD

DTQ-20010808035313
Original posting 22 Aug 2001
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:26
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