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10 things to know about hypogylcaemia in kids

June 27, 2023

mum hugging child type 1 diabetes hypoglycaemia

A low blood glucose level, known as hypoglycaemia (also called a ‘hypo’ or a ‘low’) is one of the most important things to monitor when a person is living with type 1 diabetes (T1D).

Hypos are a normal part of life for people with type 1 diabetes – in fact, most children have a hypo every now and then (and they often have them up to four times a week!).

It’s important to learn how to treat and try to prevent hypos. Here are the top 10 things you need to know about them.

1. What causes a hypo in children?

Hypoglycaemia happens when blood glucose levels (BGLs) fall too low, with a level below 3.9mmol/l.

Hypos happen when there’s an imbalance between insulin, food and exercise, and your child has received too much insulin for their needs that day. The brain then doesn’t have enough glucose to function normally, and the body releases adrenaline to try and raise BGLs. This causes hypo symptoms.

Common hypo causes include exercising without decreasing insulin amounts, or without eating extra carbohydrates (carbs); missing meals or eating them late, with not enough carbs; or dosing too much insulin.

In teens and adults, hypos can be caused by drinking alcohol.

2. What are the signs of a hypo in kids?

Many children look and feel unwell when experiencing a hypo. Hypos can cause symptoms including:

  • paleness
  • headaches
  • sweating
  • dizziness
  • feeling hungry
  • blurred vision
  • confusion, inability to concentrate
  • irritability, crying
  • weakness.

At other times, children may not show or feel symptoms (especially infants and younger children).

3. How do you fix a mild or moderate hypo in children?

Fast-acting carbohydrates raise BGLs quickly and should be carried at all times. Some popular hypo treatments are glucose tabs or gels, fruit juice, soft drinks (not diet) and honey.

Jellybeans or other lollies are also popular choices, especially for children. Keep in mind that lollies can take a little longer to work as the body processes the other ingredients.

Some people experiment and find it best to follow up with a slow-acting carbohydrate like bread, a biscuit or some milk.

Speak to your diabetes educator for advice best suited to your child’s T1D management

4. What happens during a severe hypo in children?

Severe hypogylcaemia happens when a person with T1D has low blood sugar levels that result in them being extremely drowsy or disorientated, unconscious, or having a fit or convulsion. It’s not defined by an actual number, but a worsening of symptoms that might make them unable to consume standard hypo treatments.

If this happens to your child, put them in the recovery position and administer a glucagon injection. Call an ambulance if you don’t have a glucagon injection close by, if you’re unsure what’s happening, or if they don’t improve quickly.

5. Should I trust the meter or my child’s feelings?

Blood glucose meters and continuous glucose monitors (CGMs) are invaluable for identifying when blood sugar levels are dropping and rising again after hypo treatment.

Don’t let the CGM replace how you child is feeling, though – encouraging your child to listen to their body is an important life lesson.

6. Do hypos lead to more hypos?

The day or so after having a hypo (especially if it’s a severe one), the liver is depleted of stores of glycogen. This can make your child more susceptible to another hypo. Monitor them closely and adjust their insulin and food if required.

7. What about night hypos in kids?

Night hypos are a genuine fear for parents of children with T1D, as some children can sleep through hypos. They’re more likely to happen if your child has done a lot of exercise that day, if they’ve eaten poorly, or if they’re unwell.

Regular finger pricking or a CGM is your best defence against night hypos, and will help you identify patterns. Checking BGLs before bed is a good idea, as you can then give them carbs as needed, while checking BGLs in the middle of the night can also help.

8. Can a child make a hypo happen?

Some children learn that hypos mean a sugar treat or a break from the learning at school, so they then try to convince their parent or teacher they’re low when they’re really not. Others may deliberately not match their food intake with insulin doses so a hypo might occur.

Always check BGLs before treating a hypo, and remind your child that it’s a serious matter.

9. Will a child feel better straight after a hypo treatment?

Hypo symptoms should subside when their BGLs return to a normal range.

Your child may get a headache or experience temporary memory or concentration problems afterwards. It can help to get some extra rest and monitoring, as well as paracetamol if needed.

10. When should I speak to my child’s healthcare team about hypos?

Speak to your healthcare team if hypos are happening more than five times a week, if they tend to occur at the same time of day, if they’re happening regularly at night, or if a severe hypo occurs.

As always, remember that your team is there to answer any questions you may have, and to give you tips to manage your child’s diabetes. Never be afraid to reach out for support and information.

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