Hypoglycemia in Children

What is hypoglycemia?

Hypoglycemia is the condition of having a glucose (blood sugar) level that is too low to effectively fuel the body's blood cells. Glucose is the main source of fuel for the body. The good range of blood sugar, depending on the timing and nutritional content of the last meal consumed, is approximately 70 to 140 mg/dl (milligrams of glucose per deciliter of blood). However, consult your child's doctor for more specific information.

Hypoglycemia may be a condition by itself, or may be a complication of diabetes or another disorder. Hypoglycemia is most often seen as a complication of overdoing insulin in a person with diabetes, which is sometimes referred to as insulin reaction.

What causes hypoglycemia?

Causes of hypoglycemia in children with diabetes may include the following:

• Too much medication; for instance, too much insulin or oral diabetes medication 

• Inaccurate blood-glucose readings 

• A missed meal

• A delayed meal

• Too little food eaten, as compared to the amount of insulin taken

• More exercise than usual

• Diarrhea or vomiting 

• Injury, illness, infection, or emotional stress 

An additional cause of hypoglycemia in children includes a group of conditions called hyperinsulinism. This may occur as a result of abnormal cell development of the special "beta" cells in the pancreas that secrete insulin or from a mass in the pancreas. Some children are also born with errors in their beta-cell metabolism that can lead to hypoglycemia.

Other causes of hypoglycemia in children are rare. However, hypoglycemia may occur after strenuous exercise, during prolonged fasting, or as a result of taking certain medications or abusing alcohol.

Why is hypoglycemia a concern?

The brain depends on blood glucose as its main source of fuel. Too little glucose can impair the brain's ability to function. Severe or prolonged hypoglycemia may result in seizures and serious brain injury.

What are the symptoms of hypoglycemia?

The following are the most common symptoms for hypoglycemia. However, each child may experience symptoms differently. Symptoms may include:

• Shakiness

• Dizziness

• Sweating

• Hunger

• Headache

• Irritability

• Pale skin color

• Sudden moodiness or behavior changes, such as crying for no apparent reason

• Clumsy or jerky movements

• Difficulty paying attention, or confusion

• Tingling sensations around the mouth

The symptoms of hypoglycemia may resemble other problems or medical conditions. Always consult your child's doctor for a diagnosis.

How is hypoglycemia diagnosed?

In addition to a complete medical history and physical examination, certain blood tests are performed to diagnose hypoglycemia.

When a child with diabetes has symptoms of hypoglycemia, the cause is usually an insulin reaction.

For those who have symptoms of hypoglycemia and do not have diabetes, the underlying disorder is diagnosed by:

• Measuring blood sugar and multiple hormone levels while the child is experiencing the symptoms

• Observing that the symptoms are relieved when the child eats food or sugar

Specialised lab tests to measure insulin action may also be performed.

What is the treatment for hypoglycemia?

Specific treatment for hypoglycemia will be determined by your child's doctor based on:

• Your child's age, overall health, and medical history

• Extent of the disorder

• Your child's tolerance for specific medications, procedures, or therapies

• Expectations for the course of the disorder

• Your opinion or preference

For children with diabetes, the goal of treatment is to maintain a safe blood sugar level. This involves testing blood sugar often, learning to recognize oncoming symptoms, and treating the condition quickly, based on instructions given by your child's doctor.

To treat low blood sugar immediately, your child should eat or drink something that has sugar in it, such as orange juice, milk, cake icing, or a hard candy. For children who do not have diabetes, treatment for hypoglycemia may include:

• Avoiding foods high in carbohydrates

• Eating smaller meals more frequently

• Frequent snacks

• Eating a variety of healthy foods

• Regular exercise

Children who have hyperinsulinism may require treatment with medications to decrease their production of insulin. In serious cases, the child may have to undergo surgery to remove the pancreas.