Hypoglycemia is the term used for when you have too little sugar in your blood. Low blood sugar comes on quickly and must be treated right away by your child, family, or friends. If the low blood sugar continues too long, the brain can be harmed. Because the brain grows very rapidly in the first 4 years of life, it is particularly important to prevent severe low blood sugar in young children. Early treatment helps prevent a more severe reaction. It is very important that the family and other people taking care of your child know the signs and symptoms of hypoglycemia. Your child has low blood sugar if the result of a blood sugar test is less than 60 mg/dl or 3.3 mmol/L. Symptoms of low blood sugar usually occur when the blood sugar falls below 70 mg/dl (3.9 mmol/L).
Low blood sugar occurs when the body doesn't have enough sugar to burn for energy and the level of sugar in the blood falls too low. Frequent causes include:
It is important to recognize low blood sugar as early as possible so that it does not progress to a severe reaction. Symptoms of low blood sugar range from mild to severe.
A loss of consciousness and seizures occur late in the reaction. They usually happen only if a reaction is not treated quickly enough. Hunger, shakiness, sweats, and pale or red color are caused by the release of a hormone called adrenaline (also called epinephrine). The other symptoms listed above are more related to the lack of sugar to the brain. You may be able to help your child learn to recognize the signs of low blood sugar. You may tell a young child, for example "Remember how you felt shaky and you came and told me? You did a good job! Remember to tell a grown up if you feel that way again." You may be able to know when a very young child has low blood sugar by the child's cry or behavior.
Your child may wake up with symptoms (infants may just cry) when low blood sugar occurs during the night. Your child probably has low blood sugar if he wakes up alert, sweating, with a headache, with a fast heart rate, or feeling foggy-headed. If your child wakes up with any signs of low blood sugar, test the blood sugar right away. Also think about what was different the previous day (extra exercise, extra insulin, less food, etc.). This will help you learn how to prevent a similar occurrence in the future. Note insulin reactions in your record book.
Insulin reactions come quickly and should be treated at once by your child, parent, friend, or teacher. The general rule is to give sugar in some form as fast as possible.
If the reaction is mild, take a blood sugar test first.
Your child should rest at least 10 minutes after eating and repeat the blood sugar test to make sure it is above 70 mg/dl (3.9 mmol/L) before returning to normal activity.
Severe Reaction (loss of consciousness, seizure)
Gradually, your child will become familiar with the types of reactions that occur. You and your child will learn how severe the reactions tend to be, when they are most likely to occur, and how best to treat them.
Delayed hypoglycemia means your child has low blood sugar several hours after exercising. It may occur 3 to 4 hours or up to 12 hours after exercise. This can sometimes cause an insulin reaction in the middle of the night.
To prevent delayed hypoglycemia:
More and more people with Type 1 diabetes now use continuous glucose monitors (CGM). A CGM is a device that can record glucose readings every 1 to 10 minutes, day and night, for up to 7 days. The CGM sensor is placed under the skin. An alarm can be set for a specific low glucose level, or when a low glucose level is predicted. This can help prevent severe reactions.
You can help prevent hypoglycemia by following these guidelines: