Low Blood Sugar in Children (Hypoglycemia): Symptoms, Causes, and Treatment
Low blood sugar, or hypoglycemia, in children occurs when blood sugar levels drop below 70 mg/dL. This condition can be dangerous and, if not treated promptly, can cause serious complications such as seizures, loss of consciousness, and brain damage. Below, we will examine the causes, symptoms, treatment, and prevention of hypoglycemia in children.
1. Symptoms of Low Blood Sugar in Children
Low blood sugar may be sudden and the child may experience a variety of symptoms. Some common symptoms include:
. Early symptoms:
Excessive sweating (even in cold weather)
Shaking hands and body
Sudden and intense hunger
Weakness and fatigue
Headache and dizziness
Heart palpitations and anxiety
. More severe symptoms:
Confusion and lack of concentration
Mood swings and unusual behaviors (such as crying or getting angry for no reason)
Blurred vision and double vision
Speech disorders (sudden stuttering)
Unbalanced gait
. Very dangerous symptoms:
Seizures and unconsciousness
Decreased level of consciousness
Coma (in severe and prolonged cases)
. Important note: If a child has a seizure or unconsciousness, never give him food or drink, as it may cause choking. In this situation, you should immediately call the emergency room.
2. Causes of hypoglycemia in children
. Common causes in diabetic children:
Excessive insulin use (injecting more than the body needs)
Eating too little food or skipping a meal
Excessive physical activity without consuming enough carbohydrates
Illness and vomiting, which reduce food absorption
Blood sugar fluctuations due to changes in diet or medications
. Causes of hypoglycemia in non-diabetic children:
Prolonged hunger and not getting enough food
Metabolic or hormonal problems (such as growth hormone deficiency or adrenal insufficiency)
Liver diseases (such as problems with glucose storage)
Severe infections and high fever
Taking certain medications (such as certain antibiotics or antimalarial drugs)
3. Immediate treatment of hypoglycemia in children
. If the child has mild to moderate symptoms of hypoglycemia:
Immediately give him 15 grams of fast-absorbing carbohydrates. This amount includes:
4 glucose tablets
½ glass of natural fruit juice (for example, orange juice)
1 tablespoon of honey or sugar
1 glass of plain milk
After 15 minutes, measure the blood sugar again.
If it is still below 70, give another dose of carbohydrates.
If the blood sugar returns to normal, give the child a snack containing protein and fat, such as bread and peanut butter, to prevent another drop.
. If the child is unconscious or has a seizure:
Lay him on his side to prevent choking.
Use injectable glucagon.
Call emergency services immediately.
4. Preventing hypoglycemia in children with diabetes
1. Set regular and balanced meals for the child.
2. Consume enough carbohydrates before exercise and physical activity.
3. Adjust insulin dose according to food intake and physical activity.
4. Always have sugary snacks (such as glucose tablets or fruit juice) available.
5. Check blood sugar levels before bed to prevent nighttime lows.
6. Monitor blood sugar more closely if there are changes in diet or activity.
5. Conclusion
. Hypoglycemia in children is a dangerous condition and requires a quick response.
. Recognizing early symptoms and taking appropriate treatment can prevent serious complications.
. By regularly monitoring blood sugar and adjusting your diet, you can reduce the risk of hypoglycemia.
6. Nocturnal Hypoglycemia in Diabetic Children
Nocturnal hypoglycemia is a common problem in diabetic children. This condition occurs when blood glucose levels drop during sleep and the child is unable to wake up naturally to correct it.
. Symptoms of low blood sugar at night
Many children do not notice low blood sugar while sleeping, but some of the following symptoms may be observed in the morning:
Restless sleep and nightmares
Profuse sweating in the sleep (wetting clothes or bedding)
Headache or dizziness upon waking
Unusual fatigue and lethargy in the morning
Sudden increase in blood sugar after waking up (dawn effect or Somogyi Effect)
. Causes of low blood sugar at night
Taking too much insulin before bed
Exercising heavily in the evening or early evening without getting enough carbohydrates
Skipping dinner or eating low-carb foods before bed
Blood sugar fluctuations due to hormonal changes in the body
. Ways to prevent low blood sugar at night
1. Check your child’s blood sugar before bed.
If the blood sugar level is less than 100 mg/dL, give him a light snack with carbohydrates and protein (such as bread and peanut butter or a glass of milk).
2. Adjust the dose of nighttime insulin.
If blood sugar drops frequently at night, it may be necessary to reduce the dose of long-acting insulin. This should be discussed with your doctor.
3. Use continuous glucose monitoring (CGM) systems.
These devices can alert you when your blood sugar is low and alert you to a problem.
4. Adjust your bedtime if necessary.
Parents can sometimes check their child’s blood sugar between 2 and 4 a.m. to prevent sudden drops.
7. The impact of nutrition on controlling hypoglycemia in children
A proper diet can prevent sudden drops in blood sugar and help stabilize glucose levels. Below, we will review some important nutritional recommendations.
. Useful foods to prevent low blood sugar
1. Complex carbohydrates:
Whole wheat bread, oatmeal, brown rice, whole wheat pasta
Sweet potatoes, lentils, chickpeas
2. Healthy proteins:
White meat (chicken and fish), eggs, low-fat dairy
Nuts (almonds, walnuts) and peanut butter
3. Healthy fats:
Olive oil, avocado, chia seeds and flaxseeds
4. Low glycemic index fruits:
Apples, pears, strawberries, plums, oranges
. Foods to avoid
. Simple and processed sugars:
Soft drinks, industrial fruit juices, sweet chocolates
White bread, cakes, industrial biscuits
. High-fat and heavy foods at dinner:
Fast food, French fries, sausages and sausages
. Caffeinated beverages in children:
Energy drinks, strong coffee and tea
8. The role of physical activity in blood sugar control and prevention of hypoglycemia
Regular physical activity is beneficial for better blood sugar control, but it must be carefully regulated so as not to cause low blood sugar.
. Check blood sugar before exercise.
If blood sugar is less than 100 mg/dL, the child should eat a carbohydrate snack (such as a banana or toast).
. During exercise, the child should listen to his body.
If he feels dizzy, weak or shaky, eat a sweet snack immediately.
. Have a proper meal after exercise.
A combination of protein and carbohydrates (for example, yogurt and fruit or eggs and whole grain bread) is essential to stabilize blood sugar.
9. Final conclusions and final recommendations
. Low blood sugar (hypoglycemia) in children can be dangerous, but it can be prevented with awareness, prevention and proper management.
. Regular blood sugar monitoring, insulin dose adjustment, proper nutrition, and exercise are important strategies for controlling this condition.
. In the event of hypoglycemia, prompt and proper treatment is very important to prevent serious complications.
10. Emergency Treatment Methods for Hypoglycemia in Children
If hypoglycemia is not recognized in time and reaches severe stages, immediate and emergency treatment is needed. In this section, we will review the different treatment methods.
. Emergency measures at home
. If the child is conscious and can eat:
Give him 15 grams of fast-absorbing carbohydrates, such as:
4 glucose tablets
½ glass of natural fruit juice
1 tablespoon of honey or sugar
1 glass of plain milk
After 15 minutes, measure the blood sugar again.
If it is still less than 70 mg/dL, give another dose of fast-absorbing carbohydrates.
If he improves, have him eat a snack containing protein and fat (such as bread and peanut butter) to prevent another drop.
. If the child is unconscious or having a seizure:
. Do not give him any food or drink, as he may choke.
. Use injectable glucagon immediately.
. Call 911 and wait for medical help.
11. The role of glucagon in treating severe hypoglycemia
Glucagon is a hormone that causes the liver to release glucose and rapidly increase blood sugar. This medication is used to treat severe hypoglycemia in diabetic children who are unconscious or unable to eat.
. Types of glucagon:
Injectable glucagon: Must be injected into the thigh or arm muscle.
Glucagon nasal spray: A newer option for quickly increasing blood sugar in emergency situations.
. When should glucagon be used?
If the child is unconscious or has a seizure.
If the child cannot eat and his blood sugar level is very low.
If the low blood sugar has not improved with oral treatments.
12. Adjusting insulin dosage to prevent hypoglycemia
One of the common causes of low blood sugar in diabetic children is excessive insulin intake or an imbalance between insulin and food. To prevent this problem, insulin dosage adjustment should be done under the supervision of a doctor.
. Important points in adjusting insulin dosage:
1. Record the child’s blood sugar pattern for several days before changing the insulin dosage.
2. If low blood sugar occurs frequently at night, the dose of long-acting insulin may be too high.
3. On days when the child is more physically active, the insulin dosage may need to be reduced or more carbohydrates consumed.
4. In case of illness (such as a cold), blood sugar levels may change and the insulin dosage may need to be adjusted.
13. The relationship of low blood sugar with specific diseases and conditions
. Hypoglycemia caused by digestive diseases:
Some digestive diseases such as severe diarrhea and vomiting can reduce the absorption of nutrients and cause low blood sugar. In these situations:
It is recommended to eat light and digestible foods (such as soup).
Blood sugar should be checked regularly.
. Hypoglycemia due to hormonal problems:
Some hormonal disorders such as adrenal insufficiency or growth hormone deficiency can cause low blood glucose levels. These children should be monitored by an endocrinologist.
. Hypoglycemia due to liver disease:
Children with liver disease may have difficulty storing and releasing glucose. Diet and drug treatment are very important for these patients.
14. Important advice for parents
1. Always have a source of fast-absorbing sugar with the child.
2. Inform teachers and school coaches about the child’s condition.
3. Teach the child to recognize the symptoms of low blood sugar.
4. Keep a blood sugar log to analyze daily changes.
5. In case of frequent low blood sugar, be sure to consult a doctor.
15. The impact of sleep, stress, and seasonal changes on blood sugar control in children with diabetes
A variety of factors, such as sleep quality, stress levels, and weather changes, can affect blood sugar control in children with diabetes. Below, we will examine each of these factors.
. The impact of sleep on blood sugar in children with diabetes
Insufficient or poor-quality sleep can increase insulin resistance and cause blood sugar fluctuations. Some common sleep problems that may affect blood sugar include:
. Insomnia or insufficient sleep:
May cause an increase in stress hormones (such as cortisol), which raise blood sugar levels.
Lack of sleep can increase appetite and the consumption of unhealthy carbohydrates.
. Sleep apnea:
Some children with type 2 diabetes may have sleep apnea, which can cause high morning blood sugar.
. Nocturnal hypoglycemia:
Can cause frequent awakenings at night and poor sleep quality.
. Strategies to improve sleep in children with diabetes:
1. Establish a regular sleep schedule (going to bed and waking up at specific times)
2. Avoid sugary foods and caffeine before bed
3. Check blood sugar before bed and, if necessary, eat a light snack
. The effect of stress on blood sugar in children with diabetes
Stress can cause the secretion of hormones such as adrenaline and cortisol, which increase insulin resistance and raise blood sugar levels.
. Causes of stress in children with diabetes:
Worries about insulin injections or blood sugar control
School problems, exams, and social pressures
Sudden changes in life (such as moving, family problems)
. Ways to reduce stress in children with diabetes:
1. Teaching stress management skills such as deep breathing and mindfulness exercises
2. Relaxing activities such as painting, music, light exercise (yoga, walking)
3. Creating a calm and supportive environment at home and school
. The effect of seasonal and weather changes on blood sugar
. Cold weather (winter and fall):
May increase the need for insulin, as physical activity decreases.
Cold can reduce blood flow to the skin and slow down the absorption of insulin.
. Hot weather (summer and spring):
Heat can speed up the absorption of insulin and increase the risk of hypoglycemia.
Excessive sweating may mask the signs of low blood sugar.
. Important tips for managing blood sugar during seasonal changes:
1. In cold weather, maintain regular physical activity to prevent high blood sugar.
2. In hot weather, check blood sugar levels more often and prevent dehydration.
3. Proper storage of insulin: Avoid exposing insulin to heat or freezing.
16. The effect of puberty on blood sugar in children with diabetes
. During puberty, hormonal fluctuations can cause increased insulin resistance, which may increase the need to adjust insulin doses.
. Some signs that indicate that a child needs changes in diabetes management during puberty:
Unexpected increase in blood sugar, especially in the mornings
Increased need for insulin without changes in diet or physical activity
Changes in sleep and appetite patterns
. Blood sugar management during puberty:
1. Accurately record blood sugar levels and check for hormonal changes
2. Increased monitoring of insulin doses and adjustment if necessary
3. Maintain physical activity and a balanced diet
17. General advice for parents in managing diabetes in children
1. Always carry an emergency kit containing glucagon and fast-absorbing sugar sources.
2. Teach the child to recognize the symptoms of low blood sugar and take action in a timely manner.
3. Coordinate with teachers and school officials to support the child in times of need.
4. Regular medical follow-up and adjusting the treatment plan based on the changes in the child’s life are essential.