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Dr. Andrew Rynne

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Suggest treatment for nausea and low BP in a child

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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2207 Questions

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Posted on Fri, 3 Mar 2017 in Diabetes
Question: My 10 year old daughter has been dealing with low blood sugar, nausea, yesterday it was ketotic hypoglycemia but we got it under control...not sure what caused the nausea- but it started on Sunday morning, went away until Monday, came on strong to the point of her not being able to eat enough, today the blood sugar is still on the low side 89 at present, and she cant eat much at all. She does not have a virus, no fever, or other symtoms like that. But when she stand up it feels as though her her chest is tight and she want to lie back down.
doctor
Answered by Dr. Mirjeta Guni 25 minutes later
Brief Answer:
Some further exams needed;

Detailed Answer:
Hello and thank you for asking on HealthcareMagic!
I've read carefully your concerns regarding your daughter's health.

Nausea and vomiting associated with low blood sugar may be caused by a low cortisol level.
An overproduction of insulin is another cause, but in these cases the blood sugar is under 50 mg/dl. Of course taking medications that cause low blood sugar should be excluded.

Other than a detailed clinical examination some blood tests are also needed;

-CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
-Insulin level and C-peptide at the moment of hypoglicemia.
-Electrolytes (Sodium and Potassium in particular), calcium
-HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average).
-Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
-Kidney function tests (BUN, Creatinine)
-TSH & Free T4 (checks the thyroid)
-Cortisol level

I would be happy to review your performed tests for another professional opinion.

I am always at your disposal for any other questions whenever you need!

Wishing all the best,
Dr.Mirjeta


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Mirjeta Guni 10 minutes later
Thank you so much! My daughter does not have diabetes... the only reason we could get her blood sugar and ketones was that we had my son's supply available to us. He is Type 1. Still the same recommendations?
doctor
Answered by Dr. Mirjeta Guni 25 minutes later
Brief Answer:
A detailed clininal history and exams results needed:

Detailed Answer:
Welcome back!

In this case we are talking about hypoglycemia or low blood sugar, not Diabetes.
One of the causes of low blood sugar may be a iatrogenic intake of insulin in a normal person ( in this condition she may have applied the insulin of the brother) but in this case the blood sugar tends to be very low (under 50 mg/dl).

You haven't mentioned the lowest level founded in her yet, please let me know that, if recorded.
If it 50-70 mg/dl it may be caused by nausea and vomiting or a long fasting condition .

That is why a detailed clinical examination, history and the result of those blood tests done until now is very important.

Kind regards,
Dr.Mirjeta


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Mirjeta Guni 44 minutes later
Ok, thank you so much. Her lowest reading yesterday was 45, it lingered around 70 much of the day but got up to 100 before the day was over.
Today it has been better, she still doesnt feel well though. I was thinking the lows were from the nausea, but still don't know the cause of the nausea. A while ago she wanted to test her sugar because she felt so nauseated... thankfully it was 115. Very puzzled by the nausea.....
doctor
Answered by Dr. Mirjeta Guni 8 hours later
Brief Answer:
Good news for the correction of hypoglicemia:

Detailed Answer:
Hi again,
Yes, from your description the most probable cause of hypoglicemia and positive ketones is nausea and vomiting.
Important is that there is no tendency for further hypoglicemic events.
Regarding to nausea and vomiting cause, if they persist, the above mentioned exams are needed.
Wish her good health,
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Kampana
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