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Quick reference medical handouts used by Pediatric offices


Hypoglycemia (Low Blood Sugar) in Children




Hypoglycemia refers to low blood sugar, or more specifically,  a lower than normal blood glucose (sugar)  level. It is rarely encountered in pediatric practice outside of the newborn period, where it is a relatively common place event. Hypoglycemia is a concern since the brain depends on blood sugar 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.

A random blood sugar test is generally worthless in diagnosing hypoglycemia. Even a fasting morning blood sugar is usually not helpful. Only a timed series of tests after a standardized sugar meal (glucose tolerance test) will allow the diagnosis of hypoglycemia to be made with accuracy.

The Symptoms of Hypoglycemia (Low Blood Sugar) in Children

The symptoms caused by low blood sugar come from two sources and may resemble other medical conditions.

  • The first symptoms are caused by the release of epinephrine from the nervous system. these include sweating, pale skin color, shakiness, trembling, rapid heart rate, a feeling of anxiety, nervousness, weakness, hunger, nausea and vomiting.
  • Lowering of lowering the brain's glucose causes: headache, changes in vision, lethargy, ,restlessness, inability to concentrate or pay attention, mental confusion, sleepiness, stupor,and personality changes.

The Causes of Hypoglycemia (Low Blood Sugar) in Children

  • Insulin reaction in a child with Diabetes Probably the most common form of low blood after the newborn period is a complication of diabetes known as an "insulin reaction." The causes of this condition are:  the child receives too much insulin, the child misses a meal or is too sick from another illness to eat, the youngster eats too little food as compared to the amount of insulin taken, and more exercise than normal
  • Hyperinsulinism. Most cases of hyperinsulinism (over production of insulin) 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 genetic errors in their metabolism that can lead to hypoglycemia.
  • Reactive Hypoglycemia refers to an quick fall in the blood glucose after a meal, especially a meal rich in carbohydrates. Excessive insulin is produced by the pancreas when it is "tricked" by all the sugar in circulation into producing enough insulin for a much larger meal than was actually consumed. This excess insulin drives the blood sugar below the normal level.
  • Hypoglycemia in the Newborn. Neonatal hypoglycemia is a common problem encountered by both term and preterm infants. It can be either symptomatic or asymptomatic. Prolonged hypoglycemia may result in permanent neurologic impairment, seizures, and even death. Signs and Symptoms of hypoglycemia in the newborn are nonspecific and include: jitteriness, irritability, lethargy, seizures, apnea (periodic cessation in breathing) difficulty breathing and grunting while breathing. A number of factors cause ;ow blood sugar in the newborn:
  • During the pregnancy, the mother's blood sugar is persistently high (gestational diabetes) , the fetus' pancreas assists in controlling the excess blood sugar by producing extra insulin. When the infant is born, it no longer gets the mother's glucose, but still produces large amounts of insulin, which drives the infant's blood sugar down to dangerous levels
  • Small for gestational age or growth-restricted babies may little sugar stored in their liver and once the infant is born, no longer gets mother's glucose
  • Similarly, Premature babies, especially those with low birth weights, who often have limited sugar stored in the liver or an immature liver function.

 


 

 

 

Treatment for hypoglycemia (Low Blood Sugar)

For children with diabetes, the goal of treatment is to maintain a blood sugar level that is appropriate for each child. This involves testing blood sugar often, learning to recognize oncoming symptoms, and treating the condition quickly, based on instructions given by your child's physician. To treat low blood sugar immediately the child should eat or drink something that has sugar in it, such as orange juice, milk, 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 the production of insulin the body. In more serious cases, the child may have to undergo surgery to remove the pancreas.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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