What your child eats, their energy, stress, illness, or even a sunburn — all of these can cause changes in your child’s blood sugar. It’s normal for their blood sugar levels to go up and down throughout the day and night, and if it stays in a healthy range, it may not even be noticeable.
When your child’s blood sugar is too low (hypoglycemia), you need to take action to get their blood sugar levels back to a safe range. Without treatment, your child may be at risk for dangerous symptoms, such as fainting, seizures, or a coma.
Fortunately, you can easily treat your child’s blood sugar — during the day or at night. Here’s what you should know about keeping your child’s blood sugar levels in a healthy range.
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Phone 402-955-3871
Recognizing Hypoglycemia: Symptoms To Look For
Early symptoms of hypoglycemia include:
- Shaking
- Sweating
- Hunger
- Mood changes
- Paleness
- Weakness
- Fast heartbeat
- Headache
Later symptoms include:
- Blurry vision
- Dizziness
- Confusion
- Poor coordination
- Stubborn behavior
- Extreme sleepiness
If your child’s blood sugar levels stay low and continue to drop, symptoms will get worse. This can lead to seizures or unconsciousness if not treated immediately.
If seizures or unconsciousness occur — or if your child cannot safely swallow — do not give them anything by mouth. You need to give them Glucagon or Baqsimi right away.
Daytime Low Blood Sugars
While your child is out and about during the day, there are three main factors that can impact their blood sugar levels:
- Too little food
- Too much insulin
- Too much exercise
You should treat low blood sugars under 70 for children over 5 years old. For children that are younger than 5 years old, treat under 80 because they are not able to tell someone how they feel. Targets may be different for infants, toddlers, or children of any age who can’t speak. Be sure to talk to the Diabetes Team if you have any questions about when your child needs treatment.
Treating Low Blood Sugar During the Day
If you or your child notice symptoms of low blood sugar during the day, it’s important to begin treatment immediately.
Daytime Low Blood Sugar Treatment For Children UNDER 5 Years Old:
| Blood Sugar 50 or less | Blood Sugar 51-80 |
|---|---|
| ↓ | ↓ |
| Treat with 15 grams of fast-acting, easy to swallow carbohydrate (such as 4 ounces of juice) | Treat with 7.5 grams of fast-acting, easy to swallow carbohydrate (such as 2 ounces of juice) |
| ↘ | ↙ |
| RE-TEST IN 15 MINUTES |
|---|
| ↙ | ↓ | ↘ |
| Blood sugar still 50 or less | Blood sugar still 51-80 | Blood sugar greater than 80 |
| ↓ | ↓ | ↓ |
| Re-treat with 15 grams of fast-acting, easy to swallow carbohydrate | Re-treat with 7.5 grams of fast-acting, easy to swallow carbohydrate | Add 7.5 grams of long-acting carbohydrate if more than 1 hour before next meal or snack |
| ↘ | ↓ |
| RE-TEST IN 15 MINUTES |
|---|
Daytime Low Blood Sugar Treatment For Children OVER 5 Years Old:
| Blood Sugar 50 or less | Blood Sugar 51-70 |
|---|---|
| ↓ | ↓ |
| Treat with 30 grams of fast-acting, easy to swallow carbohydrate (such as 8 ounces of juice) | Treat with 15 grams of fast-acting, easy to swallow carbohydrate (such as 4 ounces of juice) |
| ↘ | ↙ |
| RE-TEST IN 15 MINUTES |
|---|
| ↙ | ↓ | ↘ |
| Blood sugar still 50 or less | Blood sugar still 51-80 | Blood sugar greater than 80 |
| ↓ | ↓ | ↓ |
| Re-treat with 30 grams of fast-acting, easy to swallow carbohydrate | Re-treat with 15 grams of fast-acting, easy to swallow carbohydrate | Add 15 grams of long-acting carbohydrate if more than 1 hour before next meal or snack |
| ↘ | ↓ |
| RE-TEST IN 15 MINUTES |
|---|
Nighttime Low Blood Sugars
Keeping your child’s blood sugar higher at bedtime and overnight will help to prevent their blood sugar from dropping while they’re sleeping. The greatest risk for seizures due to a low blood sugar occurs during the night.
Nighttime low blood sugars can occur because of:
- Exercise during the day, which can cause delayed drops in blood sugar
- Insulin doses that are too high
- Not eating enough carbs for the amount of insulin given
- Difficulty detecting symptoms of low blood sugar because your child is asleep
If your child is 5 years or older, they should have a nighttime blood sugar range of 90-150. If they are younger than 5 years old, their blood sugar range at night should be 100-180.
Treating Low Blood Sugar At Night
There are two ranges of blood sugars to treat if your child is low because they need more carbohydrates if their blood sugar is less than 50.
Nighttime Low Blood Sugar Treatment For Children UNDER 5 Years Old:
| Blood Sugar 50 or less | Blood Sugar 51-100 |
|---|---|
| ↓ | ↓ |
| Treat with 15 grams of fast-acting, easy to swallow carbohydrate (such as 4 ounces of juice) | Treat with 7.5 grams of fast-acting, easy to swallow carbohydrate (such as 2 ounces of juice) |
| ↘ | ↙ |
| RE-TEST IN 15 MINUTES |
|---|
| ↙ | ↓ | ↘ |
| Blood sugar still 50 or less | Blood sugar still 51-100 | Blood sugar greater than 100 |
| ↓ | ↓ | ↓ |
| Re-treat with 15 grams of fast-acting, easy to swallow carbohydrate | Re-treat with 7.5 grams of fast-acting, easy to swallow carbohydrate | Give 7.5 grams of long-acting carbohydrate with protein |
| ↓ | ↓ | ↓ |
| ↓ | ↓ | Check blood sugar at midnight and 3 AM or within 3 hours |
| ↘ | ↓ |
| RE-TEST IN 15 MINUTES |
|---|
Nighttime Low Blood Sugar Treatment For Children OVER 5 Years Old:
| Blood Sugar 50 or less | Blood Sugar 51-90 |
|---|---|
| ↓ | ↓ |
| Treat with 30 grams of fast-acting, easy to swallow carbohydrate (such as 8 ounces of juice) | Treat with 15 grams of fast-acting, easy to swallow carbohydrate (such as 4 ounces of juice) |
| ↘ | ↙ |
| RE-TEST IN 15 MINUTES |
|---|
| ↙ | ↓ | ↘ |
| Blood sugar still 50 or less | Blood sugar still 51-90 | Blood sugar greater than 90 |
| ↓ | ↓ | ↓ |
| Re-treat with 30 grams of fast-acting, easy to swallow carbohydrate | Re-treat with 15 grams of fast-acting, easy to swallow carbohydrate | Give 15 grams of long-acting carbohydrate with protein |
| ↓ | ↓ | ↓ |
| ↓ | ↓ | Check blood sugar at midnight and 3 AM or within 3 hours |
| ↘ | ↓ |
| RE-TEST IN 15 MINUTES |
|---|
Carbohydrate Ideas
Whether during the day or at night, it’s important to give your child the right amount of carbohydrate to get their blood sugar levels back to normal. Always have treatment for lows with your child.
7.5 grams fast-acting carbohydrate ideas include:
- 1⁄4 cup (2 ounces) juice
- 1⁄4 cup of regular soda pop
- 1⁄2 tablespoon sugar
- 1⁄2 tablespoon syrup
- 1⁄2 tube glucose gel
- 1⁄2 tablespoon regular jelly
15 grams fast-acting carbohydrate ideas include:
- 1⁄2 cup (4 ounces) juice
- 1⁄2 cup of regular soda pop
- 1 tablespoon sugar
- 1 tablespoon syrup
- 3-4 glucose tabs
- 1 tablespoon honey
7.5 grams long-acting carbohydrate ideas include:
- 1⁄2 slice of bread
- 2 graham cracker squares
- 3 saltine crackers
- 21 goldfish crackers
- 1⁄4 cup chocolate milk
- 1⁄2 cup milk
- 4 ounces of formula/breastmilk
- Any 7.5 gram carbohydrate item
15 grams long-acting carbohydrate ideas include:
- 1 slice of bread
- 3 graham cracker squares
- 6 saltine crackers
- 1⁄2 cup chocolate milk
- 1 cup milk
- Any 15 gram carbohydrate item
Remember:
- 1⁄4 cup = 2 ounces
- 1⁄2 cup = 4 ounces
Do you still have questions about managing your child’s blood sugar levels during the day or at night? Contact the diabetes team at Children’s Diabetes Center, Children’s Nebraska at 402-955-3871 for more information about how to treat your child’s blood sugar levels to keep them safe.