My fifteen year old son has had four seizures in the past seven years, one this summer while at basketball camp. He was diagnosed at age four, and is in great health. He plays sports in high school and is a black belt in tae kwon do. His blood sugar seems to drop suddenly at times, and without a warning will go into a seizure. What can he do to prevent this from happening? He is very conscientious about his meals and snacks, but if he does miss one, he is gone.
Thanks for your attention.
This question was referred to several members of the Diabetes Team, who have each given an answer:
Answer from Dr. Lebinger:If I am interpreting your question correctly, you are implying that your son has seizures when he skips a snack or meal. It is important to sympathize with your son that he has to eat even when he doesn't want to, but to emphasize that it is essential that he eat all his snacks to avoid these seizures. It is especially important to be prepared with extra food when he is away from home, on a different schedule, and very active.
If he is having seizures without warning even when he eats appropriately, you may want to discuss with his physician possibly aiming for slightly high blood sugars. Individuals who have many low or low normal blood sugars may lose the early warning symptoms of low blood sugars which can warn you to eat extra food before you pass out or have a seizure. This has been called hypoglycemia unawareness. Many of these individuals will regain the early warning symptoms if they have fewer low or low normal blood sugars.
It might also help if your son would test his blood sugar more frequently when away and very active so he can eat extra food if his blood sugar is falling.
Answer from Dr. Robertson:There have been several questions about diabetes and sport recently.
It would certainly be wrong to discourage your son from participating in sport but some careful observation and planning should reduce the likelihood that he will have a severe hypo. You should make sure that he eats extra carbohydrate before exercise (something with sugars and starch is best, e.g., muesli bars) and checks a blood sugar before and after. This information will help you judge whether you got it right or not. Discuss with your Diabetes Team whether to cut his insulin dose on these days. Exercise increases the body's sensitivity to insulin and hypos can occur several hours later (even the next morning) so you should check more sugars until you know his usual pattern.
If your son's diabetes is very tightly controlled he may have lost some of his warning symptoms of hypoglycaemia -- speak to your Diabetes team about remedies for this.
Original posting 20 Sep 96
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