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From Virginia, USA:

My 4-year-old granddaughter has been tested and proven positive that she has hypoglycemia. She was to be tested further, but the testing was to upsetting to her, so my son and his wife decided to wait on testing further. She has the signs, that I read in your other question-and-answer information such as sweats, constant need for drinking, bellyache then relief with eating, and symptoms of stress until she eats something. Is she is at high-risk for diabetes and is there anything that can be done to prevent it?


Type 1 Diabetes may present in young adults with hypoglycemia, but it would be very unusual indeed for this to happen in a four year old. There are also more common causes of hypoglycemia which may require investigation. It is true, of course, that diabetes could be diagnosed at this stage by measuring insulin release in response to a glucose load or by assessing certain antibodies in blood. There is some evidence also that if this were the case that insulin dependence could be deferred in a number of ways. However in the absence of a family history and in view of the fact that she was so upset with the earlier investigations I am sure that the wisest course is to defer further tests and to give symptomatic treatment an opportunity to work.


[Editor's comment: There are other disorders that can mimic hypoglycemia, and it is advised by another of our Diabetes Team that further workup be pursued at this time, as missing other diagnoses such as hypopituitarism or polyglandular autoimmune disease could be disastrous if the child were to develop an intercurrent illness. WWQ]

Original posting 2 Dec 96


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