Low blood sugar, or hypoglycemia, is a condition that may arise as a side effect of diabetes treatment. Children with type 1 diabetes are not able to make their own insulin, a hormone needed for sugar transport. Rather than entering the body's cells, sugar accumulates in the blood, leading to dangerous complications. This is why children with type 1 diabetes require outside sources of insulin to survive. However, the common side effect -- hypoglycemia -- is also life-threatening, so it is important to know the signs and symptoms that are characteristic of hypoglycemia.
Elevated Heart Rate
A heart rate over 100 beats per minute is called tachycardia. This is one of the early indicators that a child's blood sugar has fallen and usually occurs at blood sugar levels between 40 and 70 milligrams per deciliter (mg/dL). This symptom occurs because the autonomic response -- the "flight or fight" response of the body to perceived or real stress -- is activated. In a patient with hypoglycemia, autonomic symptoms act as an "alarm" system. If a child feels that her heart rate is increasing, especially in conjunction with other signs or symptoms, she should check her blood sugar level and, if it is low, eat about 15 grams' worth of fast-acting sugar.
Unusual Perspiration
Another symptom suggesting low levels of blood sugar in children is a rather sudden onset of perspiration. Excessive sweating, especially if there is no clear reason for the child to be doing so, is a possible indication that blood sugar levels are dropping. Sweating is another signal that the autonomic response has been activated. A blood sugar less than 70 mg/dL should be treated quickly. Options for fast-acting glucose include a glass of milk, half a cup of non-diet soda or fruit juice, or a tablespoon of honey.
Hypothermia
An abnormal finding that is not felt by the patient is a sign. One that the patient feels is considered to be a symptom. An abnormally low body temperature may be considered a sign of hypoglycemia in a child -- she may not know that her temperature is too low. This sign is an ominous one, as it suggests that the "neuroglycopenic" part of hypoglycemia has developed. This means that the brain itself is now low on sugar and is responding. Neuroglycopenia generally occurs when levels of blood sugar are extremely low -- between 10 and 50 mg/dL. This is a dangerous situation, as neuroglycopenia may lead to a loss of consciousness.
Behavior Changes
The American Diabetes Association lists behavior changes as indicators of low blood sugar. This symptom of hypoglycemia may be as subtle as unusual irritability, or as obvious as an outburst of crying for no clear reason. If a parent notices that a child is acting "out of character" -- especially if this unusual behavior is accompanied by other symptoms -- doing a quick blood sugar check is a good idea. Behavior change is a neuroglycopenic symptom.
Seizures
An especially alarming symptom of hypoglycemia is that of seizures -- movements or behaviors that may be accompanied by a loss of consciousness. A seizure is an outward manifestation of abnormal electrical activity within the brain. In cases of severe hypoglycemia, the abnormality is occurring because of the glucose deprivation within the brain. A seizure is a dangerous manifestation of neuroglycopenia because of the risk of head injury during a fall. A parent who notices her child having a seizure should make sure the child is safe, check a blood sugar level if possible, and seek immediate medical attention.
References
- "UpToDate;" Approach to Hypoglcyemia in Infants and Children; A. Sunehag, MD, PhD and M. Haymond, MD; May 2010
- American Diabetes Association: What Are the Symptoms of Hypoglycemia?
- National Institutes of Health: MedlinePlus: Seizures
