Hypoglycemia In Children: Signs, Causes, Risks And Treatment

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If the glucose level in the blood goes below the normal range of 70 to 140 mg/dl (milligrams of glucose per deciliter of blood), it can lead to hypoglycemia. This affects the normal functioning of the cells in the body (1). Several factors contribute to hypoglycemia in children, and the condition is mostly considered a complication of insulin therapy given for diabetes.

Generally, hypoglycemia is a temporary condition. The condition is mostly harmless and treatable. However, under rare circumstances, hypoglycemia can become fatal and recurring. With timely diagnosis and treatment, medical intervention can help prevent such adverse outcomes (2).

The below post will help you know more about hypoglycemia in children, its causes, symptoms, and treatments.

Causes Of Hypoglycemia In Children

Hypoglycemia can be a condition by itself or a complication of diabetes or some other medical condition. It is mostly seen in children with diabetes and occurs when there is too much insulin in the circulating blood, also known as insulin reaction.

The following factors can cause hypoglycemia in children with diabetes (3).

  • High insulin levels in the blood
  • Overdose of diabetes medicine
  • The wrong type of insulin
  • Incorrect blood-glucose readings
  • A missed or delayed meal
  • Eating a lesser quantity of food for the amount of insulin taken
  • Diarrhea
  • Vomiting
  • Injury, illness, infection, or emotional stress
  • Celiac disease
  • Adrenal problem
  • Taking sulfonylurea, a diabetes medicine
  • Congenital problems associated with how the body processes glucose and starch
  • Rare genetic disorders

Hypoglycemia may also occur as a result of (1)

  • Excessive physical exertion
  • Fasting
  • Hyperinsulinism
  • Tumor on the pancreas (insulinoma)
  • Deficiency of growth hormone
  • Deficiency of cortisol
  • Side effect of surgeries that alter the gastrointestinal tract
  • Accidental or intentional ingestion of certain medicines
  • Alcohol consumption

Symptoms Of Hypoglycemia In Children

The symptoms of hypoglycemia may vary from one child to another. However, the following are the common symptoms of hypoglycemia in children (1) (3) .

  • Palpitations
  • Shakiness
  • Dizziness
  • Perspiration
  • Hunger
  • Headache
  • Irritability
  • Pale skin color
  • Mood swings or behavior changes, such as crying for no apparent reason
  • Clumsiness or jerky movements
  • Problems paying attention
  • Tingling sensation around the mouth
  • Nightmares
  • Confusion on awakening
  • Loss of consciousness
  • Seizure

The symptoms of hypoglycemia may resemble those of other health conditions. Thus, contact your healthcare provider for the right diagnosis if you suspect your child has hypoglycemia.

Risks And Complications Of Hypoglycemia In Children

Children with type 1 diabetes are at the highest risk for developing hypoglycemia. Insufficient glucose in the body can impair the brain’s ability to function. Thus, severe or prolonged hypoglycemia can lead to seizures or serious and irreversible brain damage (4).

Diagnosing Hypoglycemia In Children

The child’s health history, family’s health history, physical examination, and a detailed history of symptoms are the first steps in diagnosing hypoglycemia in children. Blood tests might also be done to check blood sugar levels.

For children with diabetes, insulin reaction is often responsible for the occurrence of hypoglycemia. In children with no history of diabetes and who show symptoms of hypoglycemia, the doctor may follow these steps (4).

  • Measure the blood sugar levels and levels of different hormones while the child shows symptoms of hypoglycemia
  • Check if the child feels better as soon as they consume sugary foods or drinks.
  • Perform tests to measure insulin action
  • Do a fasting study under expert supervision at the hospital

Treatment For Hypoglycemia In Children

The treatment for hypoglycemia depends on the child’s symptoms, age, the severity of the condition, and general health.

  1. For children who have diabetes, the key is to prevent hypoglycemia by maintaining safe blood sugar levels. It can be achieved by (4)
  • Regularly testing the blood sugar levels.
  • Learning to identify the symptoms.
  • Treating the condition promptly.
  1. To provide immediate relief from the symptoms of hypoglycemia, give the child something sugary, such as orange juice, cake icing, or hard candy.
  1. Avoid giving carbohydrate-rich food that is high in protein, such as milk and nuts. These food items might increase the insulin response to dietary carbohydrates.
  1. If the child shows symptoms of hypoglycemia, their blood sugar levels must be checked every 15 to 20 minutes until they are above 100 mg/dL.
  1. In case of a severe hypoglycemic condition, the child may be given a glucagon injection. If your child has frequent episodes of hypoglycemia, ask your doctor about the things you must carry with you at all times.

Preventing Hypoglycemia In Children

Most children with type 1 diabetes have episodes of hypoglycemia. However, the frequency of these episodes goes down as the child grows in age. Severe episodes can be prevented by taking the following precautions (3).

  • Test your child’s blood glucose levels often, even at night.
  • Ensure that the home test strips are not used beyond their expiry date and are compatible with the glucose testing meter.
  • Keep a keen eye on the symptoms.
  • If you notice the symptoms of hypoglycemia, treat the condition quickly.
  • Ensure that the child takes their medicines on time and does not skip any dose.
  • Make sure they eat sufficient amounts of food and at regular intervals.
  • Check their blood glucose levels before they take part in any sports or do exercise.
  • Ensure that they eat healthy snacks that include complex carbohydrates and healthy fats.

How To Help A Child Live With Hypoglycemia?

Testing the glucose level often, identifying the symptoms quickly, and treating the condition as soon as possible are vital to helping children with hypoglycemia. In addition, it is essential to ensure that the children take their food and medicines on time and exercise well.

You may seek the pediatrician’s advice to create a plan that fits your child’s routine and schedule. Explain to your child everything about diabetes, the symptoms of hypoglycemia, and the steps to manage and prevent the symptoms. Also, inform the child’s school and caregivers about their condition to ensure they know how to handle a crisis.

Frequently Asked Questions

1. Can a child grow out of hypoglycemia?

Hypoglycemia in children caused by benign reasons, such as ketotic hypoglycemia, might resolve itself. In such cases, hypoglycemia resolves when the child reaches the age of six (5).

2. What is regular blood sugar for a child?

The average blood sugar levels in a child vary with their age. For a child between zero and five years, the average blood sugar levels should be between 100 and 180mg/dl. Children between six and nine years should have blood sugar levels between 80 and 140 mg/dl. If the child is ten or above, the range is 70 to 120mg/dl (6).

Hypoglycemia in children is a treatable condition that is usually caused due to high levels of insulin in the blood, congenital problems, or deficiency of growth hormone in the body. Children with diabetes are at a high risk of this condition. Therefore, it is advised that they should keep their sugar levels in check, avoid having carbohydrates-rich foods, and know how to identify the symptoms of hypoglycemia. If you notice signs of the same on your child, consult the doctor once, as leaving it untreated might lead to seizures and other complications.

Key Pointers

  • High insulin levels, an overdose of diabetes medications, a delayed or missed meal are a few common causes of hypoglycemia in children.
  • It is characterized by dizziness, palpitation, hunger, headache, and problems with focusing.
  • Severe, undiagnosed and long-lasting hypoglycemia may lead to seizures and irreversible severe brain damage.

References:

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Dr. Ritika Shah

Dr. Ritika Shah is a certified lactation counsellor from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate... more

Dr. Dur Afshar Agha

(MS)
Dr. Dur Afshar Agha is a consultant pediatrician with decades of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association. She has also completed her Post Graduate Program... more

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