Handling Emergencies

Whether your child is a toddler or a teen, it is important that you, your child, and those close to him be aware of the signs that could signal an emergency. Severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) are both emergency situations. Hypoglycemia can lead to unconsciousness and coma. Hyperglycemia can lead to DKA, a life-

threatening situation. To prevent either situation, learn to recognize the warning signs, check your child's blood glucose right away, and treat promptly. Talk to your child's provider in advance about what to do if your child's blood glucose levels fall too low or rise too high.

Hypoglycemia. Recommended blood glucose levels are different for children and adults, because of children's high risk and vulnerability to hypoglycemia, relatively low risk of complications before puberty, and developmental and psychological issues. The blood glucose levels at which hypoglycemia is treated are also often higher than the standard recommendations for adults. Any time your child's blood glucose level falls below the value you have established, he or she may have hypo-glycemia. Signs of hypoglycemia include nervousness, shaki-ness, sweating, irritability, impatience, chills, clamminess, rapid heartbeat, anxiety, light-headedness, and hunger. When hypo-glycemia begins to affect the brain, your child may also appear sleepy, angry, uncoordinated, or sad. She may also experience nausea, blurred vision, tingling or numbness in the lips or tongue, nightmares, crying out during sleep, headaches, or strange behavior. In severe stages, confusion, delirium, personality changes, and unconsciousness can occur.

If your child is experiencing any of the symptoms of hypo-glycemia, have him check his blood glucose right away. If you don't have time to check, treat anyhow.

To treat hypoglycemia, give your child a fast-acting carbohydrate. This could be 2 to 5 glucose tablets, 2 tablespoons of raisins, half a can of regular (not diet) soda, 3 to 4 ounces of juice, or 5 to 10 jelly beans, LifeSavers, or gumdrops. In general, you want to give your child 15 to 30 grams of carbohydrate. Wait 10 to 15 minutes and test again. If her blood glucose is still low, give another dose of carbohydrate.

Plasma Blood Glucose and A1C Goals for Type 1 Diabetes by Age Group

Values by age (years)

Plasma blood glucose goal range (mg/dl)

A1C (%)

Before meals

Bedtime/ overnight

Toddlers and preschoolers (<6)

1GG-18G

11G-2GG

<8.5 (but > 7.5)

School age (6-12)

9G-18G

1GG-18G

<8

Adolescents and young adults (13-19)

9G-13G

9G-15G

<7.5*

*A lower goal (<7%) is reasonable if it can be achieved without excessive hypoglycemia.

*A lower goal (<7%) is reasonable if it can be achieved without excessive hypoglycemia.

If your child is unable to eat or shows any signs of severe hypoglycemia (confusion, delirium, or unconsciousness), she needs help right away. Call for emergency help. The quickest way to raise blood glucose levels is to give an injection of glucagon. Ask your child's health care provider or diabetes educator to show you how to give a glucagon injection and under what circumstances to give it. Glucagon requires a prescription. Make sure your child wears an ID at all times identifying her as having diabetes.

Hyperglycemia and DKA. High blood glucose levels due to insufficient insulin can lead to DKA. This is a life-threatening condition that requires immediate action. Symptoms of DKA include extreme thirst, dry parched mouth, fruity-smelling breath, and sleepiness or confusion. Your child may also have warm, dry skin with no sweating, or vomiting or stomach pain. Check her blood glucose and her urine for ketones. If your child has moderate to high levels of ketones, call your diabetes care provider right away. Talk to your provider or diabetes educator in advance to develop an action plan for when to call or go to the emergency room. In general, you should call immediately if ketones are present in the urine, vomiting occurs more than once, or your child has trouble breathing.

Parenting Teens Special Report

Parenting Teens Special Report

Top Parenting Teenagers Tips. Everyone warns us about the terrible twos, but a toddler does not match the strife caused once children hit the terrible teens. Your precious children change from idolizing your every move to leaving you in the dust.

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