When Q goes off to someone’s house and I give the parent a quick diabetes tutorial or I am training teachers, I usually tell them that knowing the signs of low blood sugar and how to treat it is the most important immediate concern. I often get questions because most people associate diabetes with high blood sugar. Insulin, activity, and a dozen other factors can make blood sugar go low.
This is an excerpt from the chapter called “Diabetes 101.” After this section on mild low blood sugar, it continues with sections on moderate and severe blood sugar.
Hypoglycemia (Low Blood Sugar)
Hypoglycemia occurs when the level of sugar in the blood falls below a certain threshold, and the body doesn’t have enough glucose to use for fuel. While it has many causes, ranging from a missed meal, exercising, a mistaken insulin dosage, or insulin given to cover a meal peaking before the carbs do, treatment involves strategies to raise blood sugar levels.
Each child with diabetes may experience low blood sugar differently and may use varying words to describe it. When Q was younger, she would often complain that she was really hungry. As she got older, she began saying that she felt shaky, that her legs were wobbly or wouldn’t work, or that she felt like she was going to “flop over.” It’s important to pay attention to your child’s particular symptoms and how he or she expresses them so you can be on the lookout for those symptoms. When Q was younger, I always told teachers that if she said she was very hungry, her blood sugar needed to be tested right away.
Your diabetes educator will teach you how to handle blood sugar lows. You’ll learn to determine if the hypoglycemia is mild, moderate, or severe, and how to react in each situation.
Mild Hypoglycemia and the Rule of 15s
For mild hypoglycemia, the “rule of 15s” can generally be followed and repeated until blood sugar rises to acceptable levels. The premise is to give 15 grams of carbs or fast-acting sugar, wait 15 minutes to allow the sugar to begin working, and retest, repeating with 15 grams of carbs every 15 minutes until the blood sugar is back in range. However, your doctor will help you figure out what is best for your child. The important thing is to test, treat, test, and repeat until the child is no longer hypoglycemic.
Fast-acting carbs include:
- 4 oz. (1/2 cup) juice, which is the size of a small juice box
- 3 to 4 glucose tablets, which have 4 carbs each
- 3 to 4 tsp of table sugar, each teaspoon is 4 g carbs
- 4 oz. (1/2 cup) of regular soda
- 10 to 15 Skittles; each Skittle is 1 g carb
- 2 rolls of Smarties; each roll is 6 g carbs
If it will be more than an hour until the next scheduled snack or meal, an additional snack including carbs and protein may be given to keep blood sugar stable. Carb plus protein snacks include small protein bars, 1 cup of milk, a cheese or peanut butter sandwich, and 3 to 6 crackers with cheese or peanut butter. Chocolates are not usually recommended for treating low blood sugar because the fat content makes them slower to absorb.
If you’d like to learn more about the book, you can read more on the Kids First, Diabetes Second book page. It’s available widely in print and as an eBook from book sellers such as Barnes & Noble, Amazon.com, and IndieBound. And if you do read it and find it to be a valuable resource, I would greatly appreciate if you could write a review on any of the online retail sites. Thanks!
Disclosure: This post contains affiliate links to booksellers.
Please remember that I never give medical advice. Ask your endocrinologist or pediatrician for advice about your own child. Make your own informed decisions for your own child.