Low blood sugars in children
If you find that these low blood sugars are happening often (more than three times a week, including at night, or ANY episode of passing out) then you MUST speak with the childâs medical provider as soon as possible. There are a number of reasons why blood sugars in children can repeatedly become low, including the following:
Reason 1: The medication dose is too high. This is often the cause and the way to fix it is to decrease the medication. Remember that people with Type 1 diabetes do not make insulin of their own, so stopping the medication entirely and permanently is not an option. But a decrease in dose is probably necessary.
Reason 2: the timing of the medication is not right. Insulin injections need to be timed as best as possible to line up with the planned meals and activity for the day. Unless you are using a peakless insulin, which is not commonly available in St Vincent at this time, then it is imperative that you speak with the childâs medical provider to be sure the insulin being used starts acting at the best possible time. A poorly timed insulin injection alone can be the cause of repeated low blood sugars, and have nothing to do with the dose of insulin or any other factors. Sometimes, moving the timing ahead or back 30 minutes is all you need to fix a situation.
Reason 3: High activity levels. Children running about the yard are great and we will never discourage exercise. BUT for just about everyone, exercise helps your body need less insulin to do the same job. So, if you notice a pattern of low sugars happening after your child has been playing, then either the insulin needs to be decreased before playing, or an extra snack should be given before going to play.
Reason 4: stress. Yes kids feel stress! Exam time comes around and sugars go all over the place. Difficult home conditions (parents fighting all the time etc) can also contribute to stress. More often the sugar levels go high, but they can also go low because of the same reasons; so, be on the lookout for that pattern.
Reason 4: other illness. Like stress, sugars more often go high when a child has another illness going on (like a cold/ flu, stomach virus etc), but sugars can also dip low, especially if the child is very sick. If there are other disease processes, like thyroid disease, going on, this can also lead to low blood sugars.
The point is the same: please speak to your doctor/head nurse about low blood sugars. It may be a straightforward reason, or it might be more difficult to sort out. It is important to get the reason (or reasons) correct so get back on the right track quickly. Remember, low blood sugars are not only scary when they happen, they are very dangerous. If you are a parent of a child with Type 1, TREAT FIRST with something sweet, then get to a clinic or call for help as soon as possible. With low blood sugars, time is critical. We will talk more next week about specific treatment of low blood sugars in children.
Until next week, stay safe and healthy Vincies!
Anita Ramsetty, MD [email protected]
Medical Director Endocrine Care Group