A 14-year-old boy with Type 1 Diabetes comes in for a routine visit. He mentions he's been feeling shaky, sweaty, and anxious, especially before meals. His blood glucose logs reveal multiple instances of pre-meal blood glucose levels below 70 mg/dL. What is the possible issue, and what is the next step?
This young boy's symptoms of shakiness, sweatiness, and anxiety, along with documented hypoglycemia, suggest he is experiencing episodes of low blood sugar, or hypoglycemia. This could be due to many factors, such as too high a dose of insulin, missed or delayed meals, or increased physical activity without adjusting insulin or carbohydrate intake. The next step would be to review his insulin regimen and his typical food and exercise routines, and then to make necessary adjustments to prevent further hypoglycemic episodes.