Hypoglycemia
A condition of low levels of sugar in the blood that causes muscle weakness, uncoordination, mental confusion, and sweating. Hypoglycemia is a very serious condition that must be treated immediately. If untreated, it can progress to a coma. Hypoglycemia can occur in any infant or child who takes insulin injections for diabetes, or in people with type 2 diabetes taking certain medications. Almost every child who takes insulin will have low blood sugar at one time or another.
Cause
When blood sugars drop too low, the brain cannot get the glucose it needs to function properly. The level at which low blood sugar gets serious depends on the child’s age, health, and whether or not the child has had hypoglycemia before.
Symptoms
The symptoms of low blood sugar range from mild to severe. Mild symptoms include hunger, sweating, headache, rapid heartbeat, and pallor. Moderate signs include irritability, poor coordination, lethargy, and confusion. Severe signs include losing consciousness or having seizures.
While severe symptoms are easy to spot, mild to moderate low blood sugar is not always easy to recognize. Some of the same symptoms might simply indicate a tired or sick child. The only way to tell for sure is to check the blood sugar levels. If for some reason a test is not possible, it is safer to assume that the cause of the child’s behavior is low blood sugar and treat the suspected low with carbohydrates. It is safer to treat a child for low blood sugar when levels are normal, than to ignore a situation in which the blood sugar is actually low.
Symptoms that a child may have low blood sugar at night include nightmares or bad dreams, stomachache or headache in the morning, ketones in the urine, and/or high or low blood glucose levels when the child wakes up. If these symptoms appear, blood sugar should be checked around midnight and again at 3 A.M. If a child is having lows during the night, the nighttime insulin dosage, type, or timing of the insulin injections may need to be adjusted. A meeting with the child’s diabetes treatment team is necessary.
The more lows a child has, the greater the risk for lows that go unrecognized in the future, because fewer warning signs actually appear. This is called “hypoglycemia unawareness.” On the other hand, symptoms of hypoglycemia can increase if the number of lows is decreased. A child who is having too many episodes of low blood sugar on a regular basis (such as every day) needs to have an adjustment in the diabetes regimen.
Treatment
To treat low blood sugar during the day, the child should immediately take 15 grams of glucose or a sugar source such as three or four glucose tablets, four ounces (half a cup) of 100-percent fruit juice, four ounces (half a cup) of regular (not diet) soda, or one tablespoon of sugar or honey.
If the symptoms do not go away in 10 to 15 minutes, the blood sugar test should be repeated. If the reading is still less than 70 mg/dl, the child should repeat the sugar treatment.
To treat low blood sugars at night, if blood sugar is below 70 mg/dl to 100 mg/dl at bedtime, the child should have one-and-a-half snacks. The blood sugar reading needs to rise to 120 mg/dl before the child goes to bed. The child’s blood sugar should be rechecked during the night, at about 3 A.M.
In the case of severe low blood sugar reading, the child should be given glucagon as prescribed. Although glucagon is rarely needed, it is vital to keep it on hand and to know how to use it if the blood sugar drops so low that the child cannot eat or drink. Glucagon is a very serious intervention. Signs that it is needed include lethargy, unconsciousness, or the inability to swallow normally. A glucagon kit usually contains a syringe with liquid, and a bottle with glucagon powder.
Prevention
It is possible to prevent hypoglycemia. Children should not skip meals or snacks, but if a child does not eat appropriately or eats less than usual during the day, blood glucose should be checked more often than usual during the rest of the day. If the blood glucose reading is too low (usually around 70 mg/dl), treatment should be given. A middle-of-the-night blood glucose reading should be done if a child has eaten less than usual during the day.
While exercise is important, extra physical activity can cause blood glucose levels to drop lower than usual, either during the exercises or much later (particularly during the night). When a child exercises more than usual, more carbohydrates (such as peanut butter and crackers) should be given.
To help prevent nighttime lows, a child’s blood sugar should be checked at bedtime and then followed with a snack. If the reading is below 100 mg/dl, it should be checked again in the middle of the night.
It is also important that everyone who cares for a child with diabetes (even school bus drivers) should know that the child has diabetes and takes insulin. They must also understand what hypoglycemia is, how to lessen the risk, and how to recognize and treat the problem. It is important to emphasize at school that a child who might be having a hypoglycemic episode should not be sent to the nurse’s office alone, even for a blood sugar check. A responsible person carrying a sugar source should accompany the child. Teachers should also understand that low blood sugar can be triggered by an altered mealtime, a skipped meal or snack, or extra physical activity. Low blood sugar can also occur at any time without an obvious reason.
Tags: causes muscle weakness uncoordination mental confusion , condition of low levels of sugar in the blood, Hypoglycemia
Posted in Health and Wellness
