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Hypoglycemia (low blood sugar) is an emergency that must be treated immediately. Without treatment, a low blood sugar may progress to unconsciousness and convulsions.
Hypoglycemia
The risk of low blood sugars can be reduced by:
- Providing extra snacks for extra activity (consult exercise guide and/or dietitian)
- Eating immediately after taking insulin if the blood sugar is less than 100 mg/dl (5.5 mmol/l)
- Eating an extra snack of carbohydrate and protein if the blood sugar is less than 120 mg/dl (6.7 mmol/l) at bedtime
- Replacing carbohydrates in the meal plan with things like regular pop, regular popsicles on sick days
- Using an insulin pump or Lantus instead of a traditional Regular/NPH insulin regimen
Treatment should be given whenever the blood sugar drops below 70 mg/dl (3.9 mmol/l) or symptoms are present.
Low Blood Sugar Symptoms and Treatment Symptoms Treatment Mild
- Grouchiness
- Shakiness
- Sweating
- Fast heart rate
- Pale skin
- Dizziness
- Yawning
Quick-acting Sugar
- 15 Grams of carbohydrate
- See Guidelines for Treating Lows by Age
- If not better in 15 minutes, repeat treatment
- If the next meal or snack is more than 30 minutes away give an extra snack of carbohydrate and protein
Moderate
- Confusion
- Poor coordination
- Inability to cooperate
- Slurred speech
Instant Glucose or Cake Frosting Gel
- Insert tube between gum and cheek
- Administer appropriate amount
- If no response in 15 minutes administer glucagon
- If the next meal or snack is more than 30 minutes away give an extra snack of carbohydrate and protein
Severe
- Unconsciousness
- Convulsions
Glucagon
- Administer Glucagon as directed (see Mini-Dose Glucagon Rescue for Hypoglycemia in Children With Type 1 Diabetes)
- Call paramedics
- Phone diabetes doctor on call
- Feed as soon as possible after awakening
- Review expiration date and instructions in the Spring and Fall
For Additional Information
- Guidelines for Treating Lows by Age
- Mini-Dose Glucagon Rescue for Hypoglycemia in Children With Type 1 Diabetes
- Emergency Glucose
- Glucagon Emergency Kit
- What do you or your child most often use to treat hypoglycemia? (CWD Poll from October 2009)
- Ask the Diabetes Team questions about hypoglycemia
- Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review. Free full text available in PDF format.
- The effectiveness of glucose, sucrose, and fructose in treating hypoglycemia in children with type 1 diabetes.
- Prediction of severe hypoglycemia.
- Hypoglycemia Preceding Fatal Car Collisions
- Diabetes, Cognition and the Brain.
- Awakening from Sleep and Hypoglycemia in Type 1 Diabetes Mellitus. Free full text available in PDF format.
- Defective awakening response to nocturnal hypoglycemia in patients with type 1 diabetes mellitus. Free full text available in HTML and PDF formats.
- Hypoglycemia in Type 1 and Type 2 Diabetes: Physiology, Pathophysiology, and Management. Also available in PDF format.
- Signs and Symptoms of Hypoglycemia and Hyperglycemia from Novo Nordisk
- Lilly Glucagon Kit Information
- Nocturnal Hypoglycemia in Type 1 Diabetes: An Assessment of Preventive Bedtime Treatments. Free full text available in PDF format.
- Nocturnal hypoglycemia in patients with insulin-treated diabetes.
- Does moderately severe hypoglycemia cause cognitive dysfunction in children?
- Hypoglycemia Prevalence in Prepubertal Children With Type 1 Diabetes on Standard Insulin Regimen: Use of Continuous Glucose Monitoring System. This study shows concludes that the "Use of standard insulin regimens results in high prevalence and large intraindividual variation in hypoglycemia, particularly at night."
- Hypoglycemia by the NIDDK
- The best defense against hypoglycemia is to recognize it: is caffeine useful?.
- Cerebral glutamate metabolism during hypoglycaemia in healthy and type 1 diabetic humans.
- Hypoglycemia and Hyperglycemia Charts in Vietnamese.
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Last Updated: Monday July 26, 2010 08:07:17
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