Hypoglycemia In Children

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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.

Mild symptoms of hypoglycemia can also be treated by eating candy or sweets. In case of a disease, hypoglycemia is cured by treating the diseases or undergoing surgery. In fact, the best solution is to adopt a healthy lifestyle, which will keep disease at bay.

For a diabetic child, the best option to treat hypoglycemia is to focus on treating diabetes. As of now, there is no cure for diabetes; therefore patients can only manage to force diabetes into remission because it will help keep episodes of hypoglycemia away from their daily lives.

Overall, parents should understand that hypoglycemia can be controlled by generating awareness among children. Parents should share information with their child, and train them to recognize signs of impending hypoglycemia. They should also talk to their children on how to react to an emergency.

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Source by Keith E. Barker