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Question:

From Oshawa, Ontario, Canada:

I've been ill for over two years with post-viral fatigue syndrome, or chronic fatigue immune dysfunction syndrome, as it is called in the U.S. I'm 20 years old now. In May, I started to notice I felt dizzy after eating food with sugar in it. I had a two hour blood glucose test, which showed hypoglycemia. Then, I had a five hour blood glucose tolerance test done.

My fasting blood glucose was 4.4 mmol/L [79 mg/dl] (should be 3.3 to 6.1 mmol/L [59 to 110 mg/dl]); my two hour reading was 2.3 mmol/L [41 mg/dl]; my three hour reading was 1.9 mmol/L [34 mg/dl]; my four hour reading was 1.4 mmol/L [25 mg/dl]; and my five hour reading was 3.6 mmol/L [65 mg/dl]. According to this, I am very hypoglycemic.

I see a Dr. Hyde, in Ottawa who treats people with chronic fatigue and he thinks I could be in the early stages of type 1 diabetes. He also suspects that I have had coxsackie B4 virus, which is thought to cause some cases of diabetes. I lost 30 pounds in only two months, between April and May. Now, I weigh only 100 pounds at 5 feet, 3 inches. I eat well and follow a diabetic diet now, as he recommended I do. I'm hungry and thirsty all the time and have been urinating a lot. I'm usually up twice in a night to urinate, too.

My C-peptides are low, though. It doesn't make much sense that they'd be low and so would my blood sugar! My c-peptide was 278 (should be 364-1655) and my insulin fasting base 15 (30-175) on the same day. I don't have Crohn's disease or celiac, both of which I've been tested for. I'm not on any medications either. Do you know what this could mean? Are there any other tests I should undergo?

Answer:

One of the problems in interpreting C-peptide data is that you have to have the simultaneous glucose level. If the glucose level is low, the C-peptide level will be low, too. I didn't see the glucose with the C-peptide level in your questions. Oral glucose tolerance tests are neither necessary or sufficient for making the diagnosis of reactive hypoglycemia. In the end, it is treated based on clinical suspicion with a diet that favors small frequent feedings throughout the day. This may not be a bad deal for you since you need to gain additional weight. The link with diabetes at this point appears unclear to me.

JTL

DTQ-20041123190902
Original posting 3 Dec 2004
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:10:00
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