Balancing blood sugar levels and understanding low blood sugars - just the basics. By the Diabetes
Education Program at The Hospital for Sick Children. This video explains how to manage
and monitor your child's diabetes. Please note the images in this video are for illustrative purposes
only and do not constitute the hospital's endorsement of a specific brand or product.
Important background information. Your child has been diagnosed with diabetes and you now have a
better understanding of why your child was feeling unwell. It is now important to understand what
factors directly affect blood sugar levels and how to balance these factors. How insulin is made.
In step one, the insulin producing cells in the pancreas make insulin. In step two, enough insulin is
being made to move all the sugar or glucose into the cells for energy and in step three, the blood sugar
levels decrease and stay in the normal range. Before your child was diagnosed with diabetes,
in step one, their insulin-producing cells were destroyed by their immune system. In step two, this
resulted in not enough insulin being made to move all the sugar or glucose into the cells for energy.
In step three, this caused blood sugar levels to increase resulting in high blood sugar symptoms.
The three main factors that are predictable, that affect blood sugar levels, are food, activity,
and insulin. Blood sugar target ranges. A normal blood sugar level in someone without diabetes
is from four to eight millimoles per liter. People with diabetes want to aim closely for this range.
When they stay within this range, they will feel well day-to-day it will result in the
best possible health and it will help to lower the risk of any long-term complications.
Day-to-day aim for blood sugar levels is to be between the target range of four to eight
millimoles per liter. If your child is an infant or toddler, this target range could be set higher.
Blood sugar balance. This balancing act can be compared to a teeter-totter in a
children's playground. When you eat, the blood sugar levels increase. When you give insulin,
the blood sugar levels decrease. And when you exercise, the blood sugar levels also decrease.
What can affect blood sugar levels? Understanding what factors impact blood sugar levels will help
you keep these factors in balance on a day-to-day basis. Carbohydrates in the food you eat will cause
your blood sugar level to increase. Activity also impacts your blood sugar level. The more
active you are the more energy, or glucose, you use causing your blood sugar level to decrease.
What is hypoglycemia? Hypoglycemia is the term used for when the teeter-totter tips,
or when your child's blood sugar level goes below their target range.
When it is less than four millimoles per liter. Low blood sugar is caused by an imbalance between
too little food. Just like yourself, your child may not always want to eat the same amount of
food at each meal. They may become busy and miss a snack, have a late meal, or even miss a meal.
Too much activity. This occurs when the amount of activity is more than the amount your child
usually participates in and/or too much insulin. This usually happens when there is an error
in the type or amount of insulin given, or when the dose of insulin needs to be lowered.
What are the signs of low blood sugar? At first you will not know what your child's specific low
blood sugar symptoms are, but in time you should be able to identify them. The early warning signs are
like how you may feel if you miss a meal. They include hunger, moodiness or irritability and
headache. Other symptoms include being pale, sweaty, dizzy and shaky. When to treat low blood sugar? You
should treat low blood sugar, or hypoglycemia, when your child's blood sugar level is less than four
millimoles per liter. If your child is an infant or toddler, this threshold could be set at a higher
blood sugar level. You should also treat low blood sugar when your child's blood sugar level is below
6 millimoles per liter and your child is having low blood sugar symptoms. This can happen when your
child is first diagnosed when their blood sugar levels can still be quite high. How do you treat
low blood sugar? First, check your child's blood sugar level with a meter to confirm their symptoms.
Then treat with a source of fast acting sugar. Some examples of fast-acting sugars are fruit juice,
milk, regular pop, skittles, Dex 4 tabs. The most effective way to treat low blood sugar
is for your child to eat a source of fast-acting sugar. How much of a fast-acting sugar you use to
treat low blood sugar is determined by the weight of your child. Always carry a type of fast-acting
sugar with you that you know your child will eat so that you have it available to treat
low blood sugar whenever it happens. Other foods, such as honey for children over one year of age,
jams, jellies, and maple syrup, can also be used to quickly increase your child's blood sugar level.
Next, wait for 15 minutes. This is the amount of time needed to raise blood sugar levels. Wash hands
and then recheck blood sugar level to be sure it has increased above four millimoles per liter.
If blood sugar level is still low, treat again with the same amount of carbohydrates as before.
If the next meal is more than one hour away or if your child is going to be active,
then give your child a snack that includes 15 grams of carbohydrates and a protein source.
This will help to prevent another low. In summary, food, activity, and insulin directly affect blood
sugar levels. These three factors are predictable, which means you have some control over how
they affect blood sugar levels. Hypoglycemia is caused by an imbalance between too little food,
too much activity, and too much insulin. Low blood sugar should be treated with a fast-acting sugar.
Always carry a type of fast-acting sugar with you to treat low blood sugar whenever it happens.
And finally, it is always helpful to think about what caused your child's low blood sugar.
Was it too little food, too much activity or too much insulin? This problem solving will
help you to try to prevent low blood sugars from happening in the future.
Thank you. We are here to help. If you have questions or need further tips, please
contact your diabetes team. For more information visit www.aboutkidshealth.ca/diabetes