Hypoglycemia
is a condition that occurs when the level of blood sugar in the body is
too low. According to the American Diabetes Association, a value of 70
mg / dL or lower is a sign of Hypoglycemia in children, who are under
treatment for diabetes. In a healthy child, without diabetes, these
values should be lower than 55 mg / dL to be considered hypoglycemia.
Generally,
children with diabetes are more prone to hypoglycemia than a normal
child. Symptoms of hypoglycemia in a child with diabetes is more common
because the diabetic child abstains from consuming sugar, which may
result in the reduction of blood sugar to a dangerous level.
In
rare cases, a non-diabetic child can also fall victim to hypoglycemia.
However, hypoglycemia in non-diabetic children is usually associated
with a disease or malfunctioning organs such as Pancreas and Kidney.
WHY DOES HYPOGLYCEMIA REQUIRE IMMEDIATE TREATMENT?
Hypoglycemia is associated with a low level of sugar in the blood.
The sugar inside our body is also known as Glucose, and glucose is
required by the body and the brain to function properly.
Accordingly,
it is important to maintain a healthy glucose level: not too high or
too low. If hypoglycemia is not treated immediately, it can worsen
quickly and deprive the brain of glucose. If you do not act soon, the
child may feel confused and unable to handle the situation. In severe
cases, the child may even lose consciousness, experience seizures or go
into a coma.
Hypoglycemia can also occur if children do not
consume enough nutrition as per their daily requirements. It can also
affect weak children if they skip a meal or exercise more than usual if
the child has diabetes.
IS THERE A RELATIONSHIP BETWEEN HYPOGLYCEMIA AND DIABETES?
As suggested, diabetic children are more prone to hypoglycemia
compared to a normal child. If a child is taking medication to control
or lower glucose level, they may inadvertently lower their glucose
levels to a dangerous level.
Medicines for diabetes affect insulin
levels, which is a hormone inside our bodies that regulate blood sugar
levels. If a child is taking one of the diabetic medicines, the blood
level inside their body can decrease in a very short span of time. If it
decreases below 70mg / dL in a diabetic child, it is usually a sign of
hypoglycemia.
In a non-diabetic child, the lowering of blood sugar
may be related to many other factors. For instance, a lot of sweating
after a rigorous exercise schedule can lead to lowering of sugar levels.
In fact, problems with the pancreas and other body parts are also a
major cause of low blood sugar in non-diabetic children.
A normal
blood sugar range is between 99mg / dL and 70 mg / dL. Depending on the
symptom, hypoglycemia can be mild, moderate, and severe. Here are some
signs and symptoms of hypoglycemia when the glucose level reaches below
70mg / dL:
Mild: below 70 mg / dL
• An intense feeling of hunger
• Nervousness and tremors
• Perspiration
Moderate: below 55 mg / dL
• Dizziness
• Drowsiness
• Confusion
• Difficulty speaking
• A feeling of anxiety and weakness
Severe: below 35-40 mg / dL
• Seizures
• Loss of consciousness, coma
SIGNS OF HYPOGLYCEMIA
Hypoglycemia rarely occurs in children except those who are actively
treated for Type 1 diabetes. Unlike adults, children should be looked
after carefully because they are often not able to feel the warning
signs. Under these conditions, doctors recommend supervising children
while they are playing or when they’re engaged in activities requiring
consistent energy. Recognizing the early signs of hypoglycemia in young
children is an important aspect of controlling the disease, which can
lead to long-term stability and cure.
Following are some examples of hypoglycemia symptoms in children with diabetes:
HEADACHE
hypoglycemia in children headache
Children who are old enough to talk can complain of a headache,
which is a potential sign of mild hypoglycemia. A young child may
indicate that he feels “funny” or the child may provide other signals
indicating a headache. For instance, young children may try to grab
their head indicating problems with the vision.
Adults should not
ignore these signs. If this happens, you can either check the glucose
level or ask questions to take appropriate action based on the answers
provided.
INTENSE HUNGER
Not all episodes of hypoglycemia start with headaches. Often, the
first sign of a mild attack triggers intense hunger. A child may
complain of hunger pains or tell you that their stomach feels empty. If
the child is well fed, complaining of intense hunger after a meal is a
potential sign of a mild attack.
On the other hand, if the child
is actively engaged in physical activity, complaining of the empty
stomach should not cause panic. Under these conditions, it is better to
let children relax and give treatment according to the situation.
NAUSEA AND VOMITING
Hypoglycemia can cause nausea and vomiting, especially in young
children. Sometimes, vomiting and nausea can occur without any sign of a
headache or hunger pains. Experts also suggest that vomiting is a
natural reaction of the body to drain itself of the toxic substance.
Perhaps,
the best thing to do is to watch for any signs of nausea. If the child
vomits without prior signs of nausea, do not panic because any abrupt
reaction to vomiting can make things worse. Just remain calm and try to
diffuse the situation as calmly as possible.
SWEAT AND PALLOR
The body often responds to hypoglycemia by releasing adrenaline,
which causes sweating and pallor. Often parents report that the child’s
skin tone turns grayish when their blood sugar is low. If you notice
signs of sweat or pallor, immediately react to these signs based on the
course of action recommended by the doctor.
Remember, sweating is a
normal process during physical activity. As such, parents should not
overreact to sweating during the passage of play and energy-consuming
activity.
DIZZINESS AND VERTIGO
Dizziness and vertigo are also common symptoms of hypoglycemia. In
young children, you may notice that they frequently fall when trying to
stand up. If you notice unusual behavior when the child tries to walk,
make the child sit or lay down to avoid possible injuries. Let the child
relax and administer the dosage as appropriate.
PROBLEMS WITH VISION
Without any prior sign of headache and weakness, blurred vision is
often a major sign of hypoglycemia. Older children are always more prone
to blurred visions compared to young children.
Whenever older
children complain of blurred or double vision, tell them to sit down or
lie on a flat surface. Whenever problems with vision occur, let children
know that they should let others know about their condition to ensure
that someone is always nearby to help.
ACCELERATED BREATHING AND TINGLING
A child with low blood sugar often breathes more quickly than
normal. They can also complain of a tingling or stinging sensation
around the mouth.
INSTABILITY, WEAKNESS, AND AWKWARDNESS
Without enough glucose to sustain brain and muscle activity, an
episode of hypoglycemia can cause loss of muscle strength and
coordination. The child can drop things or stumble when walking. Their
speech can be disjointed. In a baby, you may notice a lack of motion and
slow physical movement.
IRRITABILITY, MOOD SWINGS, AND BEHAVIOR CHANGES
irribility, mood swings, hypoglycemia in children
Lack of normal behavior is the first sign of hypoglycemia in young
children. In diabetic children, doctors often recommend looking for
abnormal signs throughout the day. If children react differently to a
normal situation, let them relax before investigating for signs.
Irritability
and sudden mood swings are common symptoms of hypoglycemia. Children
may seem anxious or nervous during such episodes. They may have a burst
of anger or cry with no apparent cause. Erratic, inappropriate behavior,
lack of cooperation, and combativeness are possible clues of low blood
sugar.
CONFUSION AND LACK OF FOCUS
Brain activity decreases when blood glucose is insufficient to feed
brain cells. As a result, an episode of hypoglycemia often causes
confusion and inattentiveness. Teachers should be aware of these and
other symptoms of hypoglycemia in case the child experiences an episode
in school.
If your child is diabetic, let teachers, friends, and
others know because they can help treat signs of diabetes and
hypoglycemia by getting help. Sometimes children and parents are
reluctant to share their feelings with others, which is a recipe for
failure. Boost your child’s confidence by telling them that it is a
normal disease that they can overcome with awareness, knowledge, and
confidence.
DROWSINESS AND LACK OF ENERGY
A severely low blood glucose level causes drowsiness and lowering of
the energy level. Signs of lack of energy are evident if you feel that
your child is yawning very frequently. In certain circumstances,
children also tend to look straight focusing on a particular spot.
Low
energy levels are also imminent if children have difficulty waking up
in the morning. If your child seems too pushy wanting to go back to
sleep, this may also be a hint of hypoglycemia in a child with diabetes.
It is also common for some children to sweat profusely at night or wet
their bedding.
SEIZURES
If levels fall below 40 mg/ dL, children can experience seizures. If
nothing is done to rectify the situation, a child can quickly go into a
coma. As a responsible parent, you should try not to panic because it
will create immense psychological pressure on your child, who would be
struggling to get out of the trauma.
Consult your child’s doctor
about emergency plans for when the child has a seizure. You should
always have a plan to deal with the most awkward situations. In fact,
make a backup plan if you’re unable to get assistance, quickly.
Knowledge and awareness are always a parent’s first line of defense
against such attacks.
WHAT TO DO IN AN EMERGENCY?
If your child is treated with hypoglycemia, you can use the
following steps to deal with the problem. Before making plans for the
treatment, always consult your doctor regarding the diet and the
procedure.
As a first step, you can give 10 to 15 grams of simple
carbohydrates orally to boost the sugar intake. For instance, you can
use these diets:
• Glucose (2 Glucosport pills),
• Sugar (2 lumps),
• Fruit Juice or non-light Soft Drinks (100 cc),
• A glass of skimmed milk (200 cc)
After giving an energy
boost, wait about 10-15 minutes to test the sugar level. If it has not
reached the normal level, it is necessary to repeat the same
carbohydrates diet. Don’t try to give more sugar than the recommended
dose because an overdose can create a chemical imbalance in the body,
which can be harmful to the recovering patient.
If glucose levels have not reached the normal level, give another 10 gram of carbohydrates. Try a long-lasting diet such as:
• 20 gram of bread
• 3 Mary cookies
• A glass of whole milk
• 2 natural yogurts
• A piece of fruit
If hypoglycemia levels are reached near a
meal, the body will react quickly to absorb carbohydrates. As a result,
you may see a quick recovery. On the other hand, if the child had just
taken a meal, the rate of absorption may be slow; therefore, you need to
be vigilant throughout the episode.
Under normal conditions, if
the blood glucose reaches less than 70 mg / dL, you should give 5 grams
of slow-absorbing carbohydrates to fulfill the appetite.
It should
be mentioned that these quantities are examples of treatment options;
however, the exact diet should be administered after consultation with
an expert. Readers should treat these guidelines to gain knowledge and
generate awareness of possible treatment options for hypoglycemia.
WHAT TO DO DURING SEIZURES?
If the child recovers after being unconscious due to an episode of
hypoglycemia or if the child experience seizures, don’t give an oral
dose. Instead, such situations are best handled by administering a
hormone known as glucagon, which is injected into the bloodstream using a
small painless syringe.
The amount of dosage depends on the age
of a child. For a child under 2 years, ¼ ampoules are sufficient. For
children between 2 and 6 years, ½ ampoules are recommended, and for
children above 6 years, a full dose of 1 ampoule should be administered.
The
dose can be easily administered at school. Parents should let school
authorities know about the health condition. Any health official at
school can control the situation by providing the required quantity.
Parents should also provide a bottle of glucagon to school authorities,
and keep a note of the expiration date.
Many schools also train
teachers to administer such doses. If the school offers such teacher
training, parents should exempt teachers from any kind of liability in
writing because it will make a trained teacher react to the situation
quickly without calling health officials to help. After the child has
recovered from the seizure or an attack, it is better to take the child
to a nearby health facility.
CAUSES OF DIABETIC HYPOGLYCEMIA IN CHILDREN
In 90% of cases, hypoglycemia or cases of low blood sugar is related
to diabetes. In these cases, the lowering of sugar is usually caused by
some mismatch between the dose of insulin supplied and food intake, or
by any medication that interferes with the effects of insulin. Low sugar
levels can also be caused by excessive exercise in diabetic children.
Children
with diabetes suffer from hypoglycemia because it often gets difficult
to control insulin and glucose balance in the body. As a result,
diabetic patients are prone to the disease due to the potential mismatch
of food, medicine, or exercise.
CAUSES OF NON-DIABETIC HYPOGLYCEMIA IN CHILDREN
In 10% of cases of hypoglycemia, diabetes is not the reason behind
hypoglycemia. In these rare cases, hormone deficiency can be the leading
cause of the endocrine-metabolic problem. The deficiency of hormone
leads to an autoimmune disease or a disease related to the heart,
kidneys or liver, which causes hypoglycemia in non-diabetic children.
Often times, hypoglycemia in non-diabetic children can also be traced to
the intake of a certain medicine used by the child.
It can also
be related to some type of tumor. The organ most responsible for
hypoglycemia in non-diabetic children is Pancreas. Pancreas balances the
production of insulin in our body; therefore, hypoglycemia can be
caused by a malfunctioning pancreas. Under these conditions, doctors try
to identify a particular disease instead of focusing on diabetic
solutions. Once the disease is rectified, symptoms of hypoglycemia tend
to fade quickly.
In non-diabetic patients, hypoglycemia is usually
caused by an enzyme deficiency, injury, or pre-diabetes. As such, there
are two types of non-diabetic hypoglycemia:
REACTIVE HYPOGLYCEMIA
The condition is mostly caused by a pre-diabetic condition where the
body has difficulty in making insulin to control glucose levels.
Another
major cause of reactive hypoglycemia is a problem with Pancreases. As
the food passes quickly through the body to the small intestine, it
causes diabetes. Often, stomach surgeries can cause such problems.
Another rare kind of diabetes is the inability of an enzyme in the body
to break down the food. This also causes the pancreas to malfunction.
FASTING HYPOGLYCEMIA
Excess use of medicines such as aspirin, antibiotics, and pentamidine can cause hypoglycemia in non-diabetic patients.
Experts
have also seen cases of a severe injury to a liver, heart, or kidney to
induce signs of hypoglycemia in healthy children. In certain
situations, the disease is genetically induced due to low levels of
hormones such as cortisol, glucagon, epinephrine, and growth hormone. A
tumor in the pancreas is also a type of fasting hypoglycemia.
DURATION OF HYPOGLYCEMIA EPISODE
An episode of hypoglycemia in non-diabetic children can often end
within minutes. The child just needs to take some kind of sweetener that
may include drinking orange juice, taking a sugar pill or eating candy.
On
the other hand, hypoglycemia caused by long-lasting insulin in diabetic
children can often take up to two days to last; however, almost all
non-diabetic children are out of the danger zone if treated
appropriately.
People with diabetes are prone to hypoglycemia
throughout their lifetime. The patient needs to be vigilant to survive
the attack. Often, patients are vulnerable at night because they cannot
monitor their glucose levels. Similarly, there are no symptoms to alert
them of the impending situation.
Repeated episodes of hypoglycemia
can lead to impaired brain functions. To prevent the condition, experts
recommend trying to reduce episodes where the levels may lead to an
attack or coma.
IS HYPOGLYCEMIA TREATABLE?
Hypoglycemia is most commonly associated with diabetes. A simple
answer to the question is, “Yes, it is treatable if diabetic children
can overcome the underlying condition causing hypoglycemia”. Depending
on the condition and severity of hypoglycemia, good eating habits,
exercise, and regular monitoring of glucose levels can prove a
long-lasting remedy to prevent damages and disease associated with
hypoglycemia.
In non-diabetic children, hypoglycemia is mostly
caused by a malfunctioning organ or a similar disease. Once doctors are
able to rectify the problem, non-diabetic children recover quickly from
hypoglycemia. Doctors also use surgery to treat tumors or replace
missing hormones with medicine to cure the disease.