children with DIABETES - Hypoglycemia



		Hypoglycemia

Hypoglycemia

Hypoglycemia (low blood sugar) is an emergency that must be treated immediately. Without treatment, a low blood sugar may progress to unconsciousness and convulsions.

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 2008)
Ask the Diabetes Team questions about hypoglycemia
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.

**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

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Last Updated: Wed Oct 21 05:49:14 2009
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