Hypoglycemia can be a very confusing symptom of diabetes to someone who is dealing with a new diagnosis or for someone who knows very little about diabetes.
Here’s why. Diabetes is due to a failed pancreas. A pancreas that is no longer producing insulin. Because the pancreas is no longer producing insulin (or producing a very small amount) the sugars in the body are not being eaten up and absorbed into the body properly. This causes the blood sugars to rise. Most people who think of diabetes, think of high blood sugars.
When a person is diagnosed with diabetes they are likely having blood sugar levels that are way above 200 (70-120 is the generally accepted normal range). Many children who are diagnosed go to the hospital with sugars in the high hundreds or even thousands. They end up being put into an ICU where they are given insulin and monitored until sugars return to a more manageable number.
When at home, management of diabetes is a challenge. On one hand, eating food can cause a diabetic’s sugars to rise. On the other hand, too much insulin, not enough food, or illness can cause sugars to drop. In our household, sugars generally like to drop in the evenings and through the night, rising in the early morning hours.
Each person is different. Likewise, each person’s diabetes is different. For us, a hypoglycemic episode is when S’s sugars are below 80. Anything below 80 is considered hypoglycemia and must be treated accordingly.
In a non-diabetic, such as T, a blood sugar of 50 or below is often considered to be true hypoglycemia.
In either case, hypoglycemia is very dangerous. Left untreated, it can cause seizures, coma, or death.
How do you know if you or your child is having a hypoglycemic episode and needs to be treated?
Here are some of the signs:
Symptoms can vary greatly from one person to another.
When my blood sugar drops, I feel it due to shakiness, hunger, headache, and a feeling of lightheadedness. I also sometimes feel like I can’t think straight. When S is having a low, he tends to lay down and can often get super sweaty. When T has a low he tends to simply scream a lot.
But both are young and are unpredictable.
Sometimes S shows symptoms and other times he runs around like he is completely fine, and yet his sugars have bottomed out. Children are difficult because they don’t always know what is going on and can’t always communicate with you.
So what do you do if you discover that your diabetic child is experiencing a hypoglycemic episode?
Here’s how we treat S’s hypoglycemia.
First, we check sugars. This is obviously how we confirm that he is actually having a hypoglycemic episode. In someone as young as S, he is unable to tell us that his sugars are dropping. We usually only discover it during our routine checks or if he is acting more lethargic than usual. When we check his sugars and find that he has a number lower than 80 we usually check it a second time to confirm the number. Test strips can fail and sometimes it was a matter of circumstances that led to the low number.
Next, it is important to give our little S some sugar. We usually choose to give him some apple juice, as it is his favorite and he doesn’t get it very often. A 4 oz box of apple juice is generally around 15 grams of sugar. For us, this is usually the perfect amount to get his sugars back into range (which for him is between 80-200). Each person is different though. For some, this is too many carbs. For others, not enough. It takes some discussion with doctors and a little bit of trial and error to figure out what works for you.
15 minutes later, sugars are checked again. If the sugars are in range then we give S a snack containing protein. One of his favorites is peanut butter crackers. But there are lots of options. String cheese, a slice of meat, peanut butter, Greek yogurt, and anything else you can think of that is high in protein will work. The idea is to get protein into his system to keep him from dropping low again.
If the protein snack has any carbs in it (such as the peanut butter crackers that have 19 carbs in it), a shot of insulin has to be administered to cover those 19 carbs.
For T or myself, non-diabetics, it is equally important to get sugars up to a normal level. We follow the same procedure, except, that we do not get any insulin to follow our snack. But we follow the same procedures in regards to food in hopes of getting our sugars back into range (above 70).
Sick days are a whole other challenge. Sickness with a diabetic is very serious and can cause a number of complications. Something as simple as a stomach bug can easily land a diabetic child in the hospital. Because there is a lot that goes into caring for a diabetic when sick, I will save the topic for another post. But the important things to keep in mind are avoiding the lows (pushing carb filled fluids like juice) and keeping ketones at bay (by administering enough insulin to keep ketones for forming). If all the child will do is drink, then keeping fluids going that are high in carbs is super important. Remember that it is better to be battling a high (which can be treated with insulin) then to be combating lows, when a child is ill. And always make sure to have glucagon on hand to use, per doctor’s instructions, if your child is low, and will not drink or eat.
Hope that this cleared up a little bit of the confusion regarding hypoglycemia in a type 1 diabetic. If you have any questions, feel free to leave me a comment to let me know and I will do my best to answer. Stay tuned for a post on Sick Day care.
I leave you with a comedic video that covers this topic. Brought to you from MRMIKELAWSON of My Life as a Pincushion, I think he does an awesome job of explaining hypoglycemia from an adult’s perspective. Enjoy!