Low blood sugar (Reference hypoglycemia Opens New Window) means that the level of sugar, or glucose, in your child's blood has dropped below what his or her body needs to function normally. When your child's blood sugar level drops below 70 milligrams per deciliter (mg/dL), he or she might have symptoms, such as feeling tired, weak, or shaky. A very low blood sugar level (below 20 mg/dL) can develop quickly and is an emergency requiring immediate care.

Sometimes people who have diabetes develop low blood sugar levels during the night. This is not likely to happen unless your child takes insulin injections. If it does happen, your child may wake up in a cold sweat and feel weak. But your child may sleep through it, because his or her body uses stored sugar to raise the blood sugar back to a target level. If this happens, your child most likely will wake up in the morning with a headache and possibly high blood sugar.

What causes low blood sugar?

Low blood sugar levels can occur if your child:

• Takes too much insulin or a Reference medicine that lowers blood sugar.
• Takes insulin or a medicine that lowers blood sugar and does not eat his or her usual amount of food.
• Exercises strenuously without eating enough.

Your child may have symptoms of low blood sugar if his or her blood sugar drops to a level lower than usual. For example, if your child's level has been in the 300s for a week and it drops suddenly to 100, he or she may have symptoms of low blood sugar. After your child has had diabetes for many years, he or she may not have symptoms of hypoglycemia until the blood sugar level is very low. This is called Reference hypoglycemia unawareness Opens New Window.

Reference Sulfonylureas can cause very low blood sugars. But very low blood sugars are most common in children who take insulin.

If your child's blood sugar drops below 40 mg/dL, his or her brain may receive too little sugar to work properly, and judgment and muscle coordination will be affected. Your child may not recognize low blood sugar and may not be aware that he or she needs to eat. You or someone else may have to help your child eat or drink something to raise the blood sugar level.

If your child's blood sugar level continues to drop below 20 mg/dL, he or she can lose consciousness and possibly die.

A low blood sugar level may soon recur, even though it has been treated. For example, some sulfonylurea medicines can continue to lower blood sugar levels for up to 24 hours. If your child's blood sugar level drops to a low level, check it frequently for some time after the low level has been treated.

Here are some ways you can manage a low blood sugar emergency.

Be prepared

• Keep some Reference quick-sugar food with your child at all times. It can raise your child's blood sugar level 30 mg/dL in 15 minutes.
• Know the Reference symptoms of low blood sugar. Post a list of these symptoms where you and your child will see it often. Have your child carry a copy at all times. Add any symptoms you have noticed in your child that are not on the list. The child may not always have the same symptoms.
• Have your child wear medical identification, such as a Reference medical alert bracelet Opens New Window Reference Opens New Window. People will know that your child has diabetes and can get help in case your child's blood sugar drops very low. See the Where to Go From Here section below to learn where to purchase medical identification.
• Teach your child's caregivers how to check blood sugar. Have instructions with the blood sugar meter.
• Post the instructions for Reference emergency care for low blood sugar in a convenient place at home and at school.

Treat low blood sugar early

• Check your child's blood sugar if you think it may be low, even if you don't see any symptoms. Follow the steps for treating low blood sugar when your child develops symptoms of low blood sugar or when your child's blood sugar is below his or her target range.

• Write down your child's symptoms and what you did. Use the blood sugar record (What is a Reference PDF Opens New Window document?).
• Let your child's doctor know if your child is having frequent low blood sugar problems. His or her medicine may need to be adjusted or changed.

Now that you have read this information, you and your child are ready to start dealing with low blood sugar levels effectively.

Talk with your child's doctor

If you have questions about this information, take it with you and discuss it with the doctor. You may want to mark areas or make notes in the margins where you have questions.

Reference Medical identification jewelry Opens New Window Reference Opens New Window can be purchased at most pharmacies. Talk with your doctor or contact the local American Diabetes Association about other places to purchase medical identification.

If you would like more information on diabetes in children, the following resources are available:

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