One common thing about diabetes is the fear of low blood sugars. I remember when my son was first diagnosed and we were taught about low blood sugar. We went home and I dreaded that first low. I was afraid of what he would feel like, and worse, what if he passed out and I had to use the glucagon!
But that first low quickly happened in a day or so, and it wasn’t as bad as I feared. He felt shaky and very hungry, but he quickly ate and felt better. Most endocrinologists want to avoid the lows in kids, but the tight control we aim for frequently leads to occasional lows. So being prepared and knowing what to do is the key.
Most people consider a low to be either less than 70, but with kids sometimes low is considered 80-90. After someone has run “high”, such as in the 300’s and up, when the blood sugar is under better control and blood sugar is at 100 they may have the symptoms of lows. Checking blood sugar is a must to see if blood sugar is low. If the blood sugar is normal but your child is having symptoms, consider whether your child is used to running high and try to wait it out and let the body adjust, or consider whether the blood sugar is dropping and the meter hasn’t “caught up” to the blood sugar.
Symptoms of Lows:
Can include, but not limited to: headache, drowsiness, trembling, blurred vision, hunger, feeling dizzy or faint, confusion, dazed look, fast heartbeat, trouble speaking.
If your child has any symptoms, or notice changes in your child with diabetes, check their blood sugar immediately.
Rule of 15: If blood sugar less is than 70 mg/dl (or whatever your healthcare professional has recommended), eat or drink 15 grams of carbs that are FAST ACTING. Fast acting carbs are a simple sugar which raise blood sugar fast. Examples include: 3-4 glucose tabs, 1/2 cup regular soda, small baggies of candy such as skittles, an airhead, lifesavers, etc. (I like to buy holiday candy in the fun packs to keep on hand for this) Don’t choose something chocolate or with a high fat content, as that will slow the rise in blood sugar.
Wait 15 minutes and recheck. If blood sugar has not come up to normal, treat with another 15 grams carbs and repeat process.
If blood sugar is less than 50 mg/dl, treat with 30 grams carbs and follow above process.
If not eating within an hour, follow the simple carbs with a snack that contains protein and carbs, such as peanut butter and crackers.
Always keep Glucagon on hand in case of unconsciousness. Read the package instructions and here’s a link on using Glucagon
Always keep snacks on hand, in the car, bags, school, and in your child’s pocket if he/she is off playing in the neighborhood, etc. Being prepared is very important for lows. Don’t get caught in the middle of nowhere with no simple carbs on hand. Trust me on this one, we’ve been there!
After any lows, evaluate the reason for low so you can prevent them as best as possible. Was there too much insulin on board, too much insulin to cover a meal, was the meal not finished, were carbs not counted correctly, or did exercise affect your blood sugars, etc? Try and correct the reason to avoid the lows, but know that they are not totally preventable, because life happens! And I promise it won’t be as scary as you are imagining!
Here’s a great free printable for the refrigerator or to give to a caregiver/babysitter/teacher on how to treat low blood sugar. Sign up here for the password!