Type 1 Diabetes and Children

Symptoms of Low Blood Sugar (Hypoglycemia)

You may be wondering, "What is considered a low blood sugar?".  A blood sugar value of 80-120 mg/dl is considered to be normal for someone without diabetes. To be extra safe in people who use insulin, a blood sugar level of less than 80 mg/dl is considered to be too low in children. As the child approaches adulthood, a blood sugar level of 70 mg/dl is considered to be too low.  Reasons for hypoglycemia could be caused by not having enough food, too much insulin, or increased activity.

Symptoms of hypoglycemia (low blood sugar), are as followed:

• Shaking
• Fast Heartbeat
• Sweating
• Dizziness
• Anxious
• Hungry
• Impaired Vision
• Weakness or Fatigue
• Headache
• Irritability

How to treat hypoglycemia

1. Test blood sugar. If less than 80 mg/dl, treat with 15 grams of fast acting carbohydrate. This my include 4 oz. of juice or regular soda, candies EXCLUDING chocolate.
2. If symptoms persist, repeat step one if blood sugar is below 80 mg/dl.

Important:  If your child is non-responsive, unconscious, or having a seizure, you will need to inject glucagon.  If you do not have glucagon, you need to call 911 immediately.

Symptoms of High Blood Sugar (Hyperglycemia)

Most children do not feel bad from hyperglycemia unless the blood sugar levels are extremely high. Once the blood sugar levels are over approximately 180 mg/dl, the kidneys spill glucose into the urine. When this happens, your child may show the following symptoms:

• Urinating more frequently
• Urinating larger volumes
• Feeling more thirsty
• Drinking a larger volume
• Increased hunger
• Feeling more tired than usual
• Blurred vision
• Irritablity
• Excessive weight loss

What causes hyperglycemia?

• Eating too many carbohydrates
• Not enough insulin
• Insulin lost strength
• Stress
• Illness
• Overuse of injection sites
• Less activity than normal
• Hypertrophy of injection sites

How to treat a high blood sugar:

If the blood sugar level is below 300 mg/dl, have your child drink plenty of sugar free fluids. Try to increase the activity in your child. You do not have to check ketone levels unless the child is ill.  

If the blood sugar level is above 300 mg/dl you will need to check for ketones. If ketones are negative, no additional insulin is required at this time. If the ketone levels are moderate or large, you will need to give your child an extra dose of insulin.  This extra dose is calculated based on the total amount of insulin you give your child in a day. For example, if your child receives a morning insulin dose of 5 NPH and 2 Novolog and an evening dose of 3 NPH and 1 Novolog, you will add all the doses together. 5+2+3+1= 11 units.  Then you take 10% of the total, which would be 1 unit.  Then take 20% which would be 2 units.  This child should receive 1 to 2 units of additional novolog to immediately treat a high blood sugar with large or moderate ketones. If an extra dose is needed, check blood sugar levels every 2 to 3 hours. A second dose of insulin can be used if the levels continue to stay over 300 mg/dl with large or moderate ketones. You will need to call an emergency person if you think a third dose is required.