What symptoms should you watch for in a child with type 1 diabetes?
Symptoms of low blood sugar include sweating, weakness, and hunger. Symptoms of high blood sugar include increased thirst and increased urination. Low blood sugar happens quickly. High blood sugar usually develops slowly over hours or days.
Treating high blood sugar in children
The best way to prevent high blood sugar emergencies is to treat high blood sugar as soon as your child has symptoms or has a blood sugar level that is well above the target range. Your doctor will give your child blood sugar goals and recommend ways to treat high blood sugar. Here are some general guidelines.
- Treat mild to moderate high blood sugar.
Follow these steps if your child's blood sugar is over the target range set by the doctor. For example, that might be over 200 mg/dL for two or more readings a few hours apart.
- If your child missed a usual dose of diabetes medicine, give your child the missed dose.
- If your doctor prescribed a dose of fast-acting insulin based on the blood sugar level (sliding scale), give your child the appropriate dose. If not, call your child's doctor for advice.
- Test your child for ketones, if the doctor has advised you to do so. Call your child's doctor if the results show a moderate-to-large amount of ketones.
- Wait 30 minutes after giving the extra insulin or the missed medicine. Then check your child's blood sugar again.
- Give your child extra liquids to replace the fluids lost through urine. Water and sugar-free drinks are best.
- Know when to take action.
- Call the doctor if your child's symptoms of high blood sugar become more noticeable or if the blood sugar level continues to rise.
- Get emergency help if your child gets drowsy or disoriented or if blood sugar continues to rise (for example, above 350 mg/dL).
- Recheck extremely high blood sugar.
Follow these steps if your child's blood sugar is extremely high—for example, over 600 mg/dL. Some blood sugar meters read only levels up to about 400 mg/dL.
- Wash your child's finger carefully before checking again. Sometimes sugar on the skin will cause a high reading.
- If the meter reads high, test the accuracy of the meter, and then recheck your child's blood sugar.
- If the meter reads high again, call your child's doctor for advice or seek emergency care.
What problems can high blood sugar cause in children who have diabetes?
In children, ongoing high blood sugar can lead to:
- The body adjusting to high levels.
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For example, if your child's blood sugar level is consistently at 250 milligrams per deciliter (mg/dL) and suddenly drops to 100 mg/dL, you or your child may think that this level is too low when it isn't. Your child may even have symptoms of low blood sugar at target blood sugar levels.
- Delayed growth and maturity.
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A child who has type 1 diabetes may grow and mature more slowly. During puberty, this can delay normal sexual development. It may also delay the start of menstruation. And your child may not gain weight properly if your child doesn't have enough insulin.
- Early complications of diabetes.
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Complications include eye, kidney, heart, blood vessel, and nerve disease. If blood sugar levels stay high, children are more likely to show early signs of these problems, especially eye and kidney disease. Also, high blood sugar levels during childhood and adolescence put your child at risk for these diseases in early adulthood.
Very high blood sugar puts your child at risk for diabetic ketoacidosis. This is a life-threatening emergency. Blood sugar levels usually rise slowly, so in most cases you can treat symptoms early and prevent this problem.
Type 1 diabetes: What puts your child at risk for high or low blood sugar?
Things that make a child with type 1 diabetes more likely to have very high or low blood sugar include:
- Young age.
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Very young children are at the greatest risk for very low blood sugar. That's because they often can't tell you about their symptoms.
- Tight blood sugar control.
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Keeping your child's blood sugar levels within a target range is important. But very tight blood sugar control puts a child at risk for frequent low blood sugar levels.
- Hypoglycemia unawareness.
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Children who have hypoglycemia unawareness aren't able to recognize early symptoms of low blood sugar until they become severe.
- Puberty.
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Growth spurts and changing hormone levels during puberty make it hard to keep a child's blood sugar level within a target range.
- Mental health conditions.
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Children who have depression, anxiety disorder, panic disorder, or eating disorders are at increased risk for frequent high and low blood sugar levels.
What can cause high blood sugar in children who have diabetes?
High blood sugar occurs when the sugar (glucose) level in the blood rises above your child's target range. It can happen if your child:
- Misses a dose of insulin or diabetes medicine.
- Eats more than usual.
- Is under emotional stress.
- Has an illness, such as the flu or an infection.
- Takes a medicine that raises blood sugar as a side effect. Examples include medicines that reduce inflammation (corticosteroids) and some decongestants.
- Starts puberty. Hormonal changes affect how well the body uses insulin. These changes can cause higher blood sugar levels.
Some children who take insulin may have very high blood sugar in the morning, even if it was low at bedtime. This could be caused by the dawn phenomenon. Talk with your child's doctor if this happens.
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