Hypoclycamia in Toddler

fletch35 said:

Hi,

This morning I had to rush my nearly 3 year old daughter to A+E, as she woke up v.sleepy, lethargic and floppy. We took her there on advice from NHS 24.

They did the basic checks and they quickly did a BM test(?) as she was still very groggy. The test came back with a reading of 1.3, the attitude quickly changed in the ward and she was very quickly admistered chocolate. It took a oreo bar, mars bar, and 2 bourbon, plus some orange juice before her blood levels started to rise. The nursing staff said she was hypoclycamic(sp). Can anyone explain this? Im totally new to diabetes and hypos.

We were A+E for nearly 4 hrs before her BM levels were an acceptable level to leave. They haven't said for definite that she is diabetic, they think this episode was an isolated incident. Of course I am worried this will happen again, so looking for advice on what to look for in case it happens again. There is a family history of both type 1 and 2 on my husbands's side. My sister in law is a carer and has a few clients with diabetes. She says that the first reading was very low. Can anyone tell me what reading she would have needed to get to be unconscious?

Her diet is quite bad, she is very fussy and for past few weeks she has been mainly eating yoghurts, cheese and fruit. I am thinking of contacting her doctor and asking for a referral to a dietian. Do you think this is a good idea and how would they help?

Sorry for all the questions, but my daughter's condition scared me this morning so looking for advice.

Lorna

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Hypoglycaemic means she had low blood sugar. Hypoglycaemia is a reading that is less than 4 mmol.
If you are having a hypo you may feel the following:
The main symptoms associated with hypoglycemia are:

Sweating
Fatigue
Feeling dizzy
Symptoms of hypoglycemia can also include:

Being pale
Feeling weak
Feeling hungry
A higher heart rate than usual
Blurred vision
Temporary loss of consciousness
Confusion
Convulsions
And in extreme cases, coma
(Taken from diabetes.co.uk).

In most cases the person having a hypo will be able to deal with this themselves by eating sugar tablets, or taking in lucozade etc. on some occasions they may need help from someone else (I have had diabetes for 15 years and have never needed help yet, so for some people this is extremely rare!)

I'm not sure at what point you may enter a coma / be unconscious. My blood sugar had been 1.2 and I have still be conscious.

I think that it might be a good idea to see a dietician despite this episode as it would be great to have ideas on how to get your child to eat more healthily and to get more nutrients.

I hope this is a one off and you aren't feeling quite as panicked now that she has been well looked after. It can't be nice to see your child so helpless. Sorry this has happened.

By the way to treat my hypos I carry dextrose tablets (you can buy them in boots and supermarkets) or some people have lucozade or fruit juice. I know she hadn't been diagnosed with diabetes but it might be useful to have these to hand just in case. However DO NOT give these to her if she is unresponsive. Instead call an ambulance.

Any questions just ask.
patch13

fletch35 said:

Hi Patch,

Thanks very much for your reply, the nurses and doctors were great, but they were buzy so didn't get a lot of info out of them.

im worried it will happen again, and im worried. We are away on holiday next week so wondering what to do if she has another attack? Do I take her in straight away or try the dextrose tablets first?

Her BM levels were 1.2, 4.3 and 8.5 but that was after filling full of chocolate, toast, and orange juice!!!

Ive also noticed that she is after sugary sweets first thing in the morning, before this morning I thought she was just trying it on! now I wonder if her body is needing it? I have to leave early in the morning for work (I have to drop her off at inlaws first) so don't always have time to give her a full breakfast. So usually give her a drink and yoghurt. She, however gets breakfast as soon as she gets to her grandpa's

What would you recommend for breakfast on a workday. The docs also suggested a supper before bed. Any ideas?

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If she is unconscious / unresponsive just take her straight to A & E. even if it turns out she is fine it is always better to waste a bit of the doctors time than for your daughter to get ill.
I would make sure you have dextrose, lucozade or fruit juice on you the whole time just in case you are concerned or think she is showing the signs of hypoglycaemia as listed above.

It sounds as if she is eating more than I first thought and as long as grandad is feeding her a breakfast I wouldn't feel guilty about just giving her juice or a yogurt. The best things to avoid hypos would probably be giving her some whole grain toast (breaks down and raises sugar lecels slowly) with something like Nutella, jam or something that may raise sugar levels more quickly (I'm recommending this as you said in the morning she may be craving sweet things because she keeps wanting sweeties). If she has already had juice or yogurt (sugary food) then she could just have toast with cheese.

I think for snacks most people have a couple of biscuits, milk, or something similar. Fruit with a biscuit could also be fine (I'm trying to think of healthy things!).

Patch13

No worries about the questions I just hope I am helping!

I have no idea how many hypos she would have to have before a diagnosis. I got diagnosed because I had high blood sugar, lost weight, was thirsty and had thrush (not good). My sugars don't just go low, they go high as well.

I would go to the doctor and ask as you are going away it would be nice to talk it through with then and ask what they recommend you doing if she is unwell. You could ask if maybe they could check her sugar levels again to see if they are ok (I don't know if they will but it could be worth asking).

I guess supper could be the 'snack' things I've listed above or maybe porridge with some fruit on, toast, fruit and a little cereal.

Patch13

I would also go with a list of questions to the doc about things you want to know / aren't sure about as they will be able to give you more specific info / advice / answer your concerns as they know her background.

our 10 year old gets grumpy even when she was 2 we could tell she was shutting down it was like she was getting drunk and grumpy, she has a weird rare condition i wont go into but look out for the grumps, we always gave her a banana, she goes to the school office now mid afternoon for the banana or she shuts down at school


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fletch35 said:

hi Patch,

The hospital recommended giving her some sort of supper before bed, to make sure her blood levels don't drop overnight, which we have done.

Do you think its worthwhile going to doctor tmorr, to discuss my concerns? The hypo seemed to come on sooo quick, but now I know the signs ill be looking out for them, although its hard to guage some signs with a 2 year old. I will also get some dextrose tablets and put some in her bag. My mum has phoned at least 3 times today, to see how she was!

How many episodes of hypo's would she need to have before they diagnose diabetes?

Sorry for all the questions!!

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Episodes of hypoglycaemia won't give a diagnosis of diabetes. You're looking at something different here.

Supper is a good idea to stop her going low over night.

I have 2 friends who both suffer from hypoglycaemic episodes but are NOT diabetics. They have never been so low as to require A&E, but they are older and know themselves when they have an issue and to get something to eat.

Definitely go to your GP and discuss it. Hopefully it'll be an isolated incident.

Also - the hospital was wrong with her treatments. Anything including chocolate is not appropriate to treat a hypo

fletch35 said:

What kind of snacks should she have during the day, so her blood levels stay ok?

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Fruit is a great snack. It's naturally sweet so it often satisfies their sweet tooth. And it's naturally high in carb.

I don't have kids of my own, but I have 5 nieces and nephews and a 6th on the way. I often babysit for my siblings and see at least 1 child most days. They are 7, 2, 1, 7 months and 3 months. I'm no expert but I help out where ever I can.

All of them (bar the youngest obviously!) love grapes and berries. Or try slicing up some apple and giving it with a piece of cheese. Or some banana. The oldest was fussy, for her it helped to put the food into funny shapes and she would then eat it. Pastry cutters to make animal shaped little sandwiches was a lunchtime favourite!

Avoid milk or any other liquid that will fill her tummy before a meal. Giving her a chance to feel hungry will make her more inclined to eat. If she's already had fruit juice etc she won't want to eat for a while!

She will sense your stress and it'll make her more jumpy. Don't freak if she won't eat, remove her plate and offer it again in 15 minutes or so. Once she realises you're not messing around anymore she'll get the message

Hypo is best treat with fluid. Many use lucozade which I'm not a fan of, so I use fruit juice. 150-200ml does it. Once her BG is up follow up with a biscuit or similar.

Jelly sweets like haribo or jelly babies are also great. 3 jelly babies, or similar. Or as previously mentioned dextrose or lucozade tablets.

The fat content in chocolate means it takes longer to take effect.

Sorry to hear of your problems, hope you get sorted soon so your daughter is feeling better.

Regarding her 'fussy' eating, it may be that the foods she is refusing to eat make her feel worse so she is afraid to eat them. When she is at the grandparents she may just be eating to be polite, or afraid if they are strict that she will be in trouble if she doesn't eat the food she is given.
Could you keep a record of what food she eats and how she feels in the next few hours after eating it maybe, you may then see a pattern emerging and find out what foods are causing her problems.

Best wishes
Angie

I doubt you would get a meter from the doctor, but if you're concerned then you can self fund one.