Diabetes is a condition in which the body lacks or is unable to use the hormone insulin. Insulin is responsible for regulating the levels of glucose, or sugar, in the body. Without insulin, the body's tissues are unable to absorb glucose to feed energy needs. This results in elevated blood sugar levels and spillage of glucose into the urine. Children with diabetes can have rapid fluctuations in their blood sugar and electrolyte levels, predisposing them to seizures.
Significance
Diabetic seizures in children can occur if their blood sugar levels are either too high or too low. Children with diabetes need regularly timed meals and snacks and appropriate doses of insulin and other medications to maintain their blood glucose levels at a normal range. Seizures in diabetic children indicate a lack of control of their blood glucose levels, possibly because parents are not following their medication and diet regimens. Once seizures are under control the parents of a diabetic child and the child himself must be told of the importance of maintaining the right blood glucose levels.
Features
The physical manifestations of diabetic seizures in children include abnormal movements of the body, with shaking, eyes rolled back and teeth clenched. Before a seizure, a diabetic child may appear listless, off-balance, sleepy and unfocused. Afterward, the child will appear groggy or lethargic, a condition called the postictal stage. The postictal stage usually lasts a few minutes. If it lasts for more than an hour, the child could still be experiencing a seizure. Prompt medical attention is required whenever a child has a seizure.
Considerations
Children with diabetes can also have seizures because of electrolyte abnormalities during diabetic ketoacidosis. During diabetic ketoacidosis, the body responds to the lack of insulin and the inability to use glucose by breaking down fat, according to the Merck Manuals. This causes an imbalance in the child's bloodstream that can lead to abnormal levels of sodium, potassium and other electrolytes. Diabetic ketoacidosis can also cause profound dehydration, as the glucose spilling into the urine draws water out of the body. The treatment of diabetic ketoacidosis includes intravenous fluids and slow correction of the levels of sodium and close monitoring of the heart and kidneys.
Treatment
The treatment of a diabetic seizure includes protecting the airway and breathing, using anti-seizure medication for prolonged seizures and identifying and correcting the cause of the seizure. One of the most important aspects is checking the blood sugar level and assessing if it is abnormal. This will give valuable information to the first responder as to the cause of the seizure and prompt him to initiate treatment--glucose if sugar is low or insulin if sugar is high.
Prevention/Solution
The best way to prevent diabetic seizures is close monitoring of blood sugar levels. This is important once a child starts therapy with insulin or other glucose-controlling agents. It is also important to maintain appropriate nutrition and follow a diabetic diet. Skipping meals is a common cause of abnormal blood sugars, especially in very active children and adolescents, and this can lead to low glucose levels and a seizure.
