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What are the treatments and assessment for a patient with elevated glucose level in blood?

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Posted on Sat, 23 May 2015
Question: My daughter is 17 and is having hypoglycemic problems cause by stress. Her pediatrician ordered blood work everything turned out great - glucose level was 97. He wants to send to her to a pediatric endocrinologist. I have the same symptoms and it is brought on by stress and I know what to do to get it normal. Would it be safe to purchase my own glucose meter and test her once/twice a day and if it's low drink juice, etc.? Both my husband and I have feelings of uncertainty regarding the endocrinologist. Thank you.
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Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer:
Glucose

Detailed Answer:
I understand what you are saying.

Hypoglycemia is a fairly complex medical condition to grasp, especially for the non-expert.

True hypoglycemia is defined as blood glucose level below 65 mg/dl. Values that fall below this threshold require a thorough and systematic evaluation.

When I see someone like your daughter in my practice, I order the following tests in addition to a through physical examination:

CBC
CMP
TSH
Free T4
Serum Cortisol at 8 am

Then I schedule a 'Prolonged Fast test' if deemed necessary.

At any point when a glucose level below 55 is registered, it is important to run several other blood tests on the same sample:

Glucose
Insulin
Pro Insulin
C peptide
Beta hydroxy butyrate
Insulin auto antibodies
IGF2
Oral hypoglycemic agent panel

and this is followed by a Glucagon injection to see if her blood glucose rises.

So as you can see it is complicated to deal with this situation.

But the first question to be answered is whether she truly has hypoglycemia or not. Your idea makes sense ie to check her with a monitor and if readings are below 60 , it is worthy of formal assessment by an endocrinologist in person
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala (1 hour later)
Thank you so much. I feel better in making my decision to buy a meter and monitor her.
doctor
Answered by Dr. Shehzad Topiwala (7 hours later)
Brief Answer:
Follow up

Detailed Answer:
You are welcome. Best wishes
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What are the treatments and assessment for a patient with elevated glucose level in blood?

Brief Answer: Glucose Detailed Answer: I understand what you are saying. Hypoglycemia is a fairly complex medical condition to grasp, especially for the non-expert. True hypoglycemia is defined as blood glucose level below 65 mg/dl. Values that fall below this threshold require a thorough and systematic evaluation. When I see someone like your daughter in my practice, I order the following tests in addition to a through physical examination: CBC CMP TSH Free T4 Serum Cortisol at 8 am Then I schedule a 'Prolonged Fast test' if deemed necessary. At any point when a glucose level below 55 is registered, it is important to run several other blood tests on the same sample: Glucose Insulin Pro Insulin C peptide Beta hydroxy butyrate Insulin auto antibodies IGF2 Oral hypoglycemic agent panel and this is followed by a Glucagon injection to see if her blood glucose rises. So as you can see it is complicated to deal with this situation. But the first question to be answered is whether she truly has hypoglycemia or not. Your idea makes sense ie to check her with a monitor and if readings are below 60 , it is worthy of formal assessment by an endocrinologist in person