When you think of diabetes, high blood sugar is likely top of mind. But drops in blood sugar, or blood glucose, are also common in kids with diabetes, especially those who require insulin therapy. This dip in blood glucose is known as hypoglycemia, or low blood sugar.

What causes hypoglycemia?

When the body has too much insulin, cells absorb a greater amount of sugar from the blood, so blood glucose levels fall. Common triggers that may cause this buildup of insulin and lead to hypoglycemia include:

• Too much diabetes medication
• Excessive exercise
• Not eating enough food to balance out insulin levels
• Skipping meals and snacks

Low blood sugar, or hypoglycemia, comes on fast and needs to be treated right away. That’s why it’s important for parents and caregivers to know the signs of low blood sugar and to respond quickly.

Once you get an idea of how hypoglycemia affects your child, be sure to also educate your family, friends, teachers and sitters—anyone in close contact with your child on a regular basis—so that they are aware of the symptoms to look out for and what to do in case your child needs help.

What are the signs and symptoms of low glucose levels in kids?

“In general, a blood sugar level below 70 is considered low,” explains Andrew Muir, MD, Medical Director of Endocrinology and Diabetes at Children’s. “But for a child with diabetes, any blood sugar level below their target range might be considered hypoglycemia. This target range varies from one kid to the next, so ask your diabetes team what a low blood sugar level is for your child."

In addition to checking your child’s blood sugar level, there are physical symptoms you can look out for that signal that their blood glucose is low. Early symptoms are typically mild, and may include:

• Shakiness
• Fast heartbeat
• Sweating
• Blurred or double vision
• Headache
• Confusion, slow thinking or trouble doing simple things
• Slurred speech
• Hunger
• Feeling moody or cranky
• Numbness
• Feeling weak or sleepy
• Having a pale, gray color to their skin
• Crying or feeling nervous
• Poor physical coordination

If early signs of hypoglycemia go untreated, your child may experience more severe problems like:

• Fainting or passing out
• Seizures

If your child shows signs of hypoglycemia, check their blood sugar immediately. If you can’t check, then trust your instincts and treat them for hypoglycemia anyway.

How do you treat low blood sugar in kids?

• Give three to four glucose (sugar) tablets, or encourage them to drink 4 oz. of fruit juice or regular soda (not diet).
• Check your child’s blood sugar again after 15 minutes. If it is still low, treat again.

If symptoms don’t subside, call your healthcare provider.

What foods should be avoided when treating kids with low blood sugar?

Glucose tablets or a sugary drink are the best options to help quickly boost your child’s blood glucose levels. Other foods might be considered sugary, but may not work as effectively. These include:

• Foods that contain cornstarch, fat or protein, because they take longer to impact glucose levels
• Chocolate, which has a lot of fat and takes a long time to digest
• Hard candy, like mints or Lifesavers, because they take a long time to dissolve and could be a choking hazard.

What can you do to prevent hypoglycemia in diabetic kids?

Careful observation and a bit of preparation can go a long way in preventing hypoglycemia. The more aware you are of how your child’s body responds in different situations—after exercise, when they’re tired or miss a meal—the better equipped you’ll be to take proactive steps to regulate their blood sugar levels.

• First, keep a record of your child’s blood sugar levels before, during and after a new activity. Be sure to note the time of day and intensity of exercise.
• Learn how to offset the effect exercise has on their blood sugar by adjusting their insulin or encouraging them to eat extra carbs.
• Carry extra snacks and sports drinks if your child’s blood sugar regularly dips near the low end of their target range.
• If blood sugar levels drop during the night or for any unknown reason, your child may need a change in their insulin or medicine dose, so be sure to discuss with your care team.