Hypoglycemia in children: causes, symptoms, treatment. How to protect a child from hypoglycemia Is hypoglycemia treated in children
Hypoglycemia in children is a condition characterized by low blood sugar, or abnormally low levels of glucose in the blood. Hypoglycemia in newborns may be one of the physiological reactions of the body to stressful changes in environmental conditions.
Hypoglycemia, also known as insulin shock, is the body's response to low blood glucose levels (less than 4 mmol/L). Hypoglycemia syndrome occurs in children with type 1 diabetes mellitus, but can occasionally occur in children and adolescents with type 2 diabetes. It is more often diagnosed in patients taking sulfonylurea drugs. , an inadequate dose of insulin, concomitant illnesses, or heavy mental and physical activity without sufficient compensation for energy costs can contribute to an attack of hypoglycemia. If left unchecked, it can lead to loss of consciousness. In very rare cases, coma may develop.
A child with hypoglycemia may quickly become irritable, sweaty, trembling, and complain of being very hungry. In most cases, eating fast-acting carbs (such as juice or hard candies) corrects the situation. Glucose can also be used in the form of tablets or solution. A child who has lost consciousness due to an episode of hypoglycemia will quickly return to normal after an intravenous glucose injection. This will help quickly bring your blood sugar levels back to normal.
Hypoglycemia in newborns
Gestational hypoglycemia in newborns is more common in infants born to women who have type 1 or type 2 diabetes during pregnancy. Careful monitoring of maternal blood glucose levels in the last months of pregnancy helps prevent this condition.
A pregnant woman's high blood glucose can cause the fetus to produce a high level of insulin in order to obtain an adequate breakdown response, and when the maternal source of glucose is lost at birth during cord cutting, the remaining insulin causes the newborn's blood sugar levels to plummet. Giving a glucose solution intravenously to a newborn can help restore normal blood sugar levels.
Reactive hypoglycemia in children
A rare type of this syndrome, known as reactive hypoglycemia in children, can occur in non-diabetic individuals. In reactive hypoglycemia, blood glucose drops to 3.5 mmol/L about four hours after the last meal, causing the same symptoms of low blood sugar that can occur in people with diabetes.
Hypoglycemia on an empty stomach is also often manifested. This is a condition in which the blood sugar level is 3.5-4.0 mmol / l in the morning after waking up or between meals. Some medications and medical procedures can cause hypoglycemia syndrome in children who do not suffer from diabetes.
Among children with diabetes, hypoglycemia is much more common in patients with type 1 diabetes (also known as insulin-dependent diabetes or juvenile diabetes) than in patients with type 2 diabetes (formerly classified as adult-onset diabetes).
Hypoglycemia and causes
The causes of hypoglycemia are hidden in the mechanisms of regulation of carbohydrate and energy metabolism in the human body. With an excessive release of insulin into the blood of a child, an attack of hypoglycemia can be provoked, regardless of his predisposition to the development of diabetes. Hypoglycemia in children and adolescents with diabetes can be caused when too much insulin is given by injection. The development of an attack can contribute to excessive physical and mental stress without proper food intake, some medications, skipping meals and eating alcoholic beverages.
Hypoglycemia in diabetes mellitus is a common occurrence with which the patient must be able to cope on their own in a timely manner.
Reactive hypoglycemia can be caused by an enzyme disorder after gastric bypass. Hypoglycemia in non-diabetic children can be caused by insulin-producing tumors, certain hormonal disorders, drugs (including sulfa drugs and high doses of aspirin), and severe physical illness. Unmotivated attacks of hypoglycemia are more common in children aged 10 years.
Hypoglycemia and its symptoms
Parents should remember that not all symptoms of hypoglycemia can be recognized without a detailed laboratory blood test. Any changes in your child's behavior and eating habits should be treated with caution. Especially if you suspect he has impaired glucose tolerance. Symptoms of hypoglycemia may include:
- unsteadiness of gait;
- nervousness and irritability;
- dizziness and drowsiness;
- increased sweating;
- , the inability to pronounce individual words and letters;
- feeling tired and apathetic;
- hunger;
- sense of anxiety.
Hypoglycemia in diabetes mellitus: when to see a doctor
Hypoglycemia in diabetes is caused by an excess of insulin and a deficiency of glucose in the baby's blood. Children who experience frequent bouts of hypoglycemia should be seen by their doctor as soon as possible. You may need to adjust your insulin, medication dose, or make other changes to your current treatment regimen.
If a child or teen with diabetes begins to show low blood sugar without any side effects, it may go completely unnoticed. However, the doctor should be aware of all changes in the condition of the sick child. The lack of timely medical care for hypoglycemia syndrome can lead to loss of consciousness.
A doctor should be contacted immediately if there are any signs that the baby is beginning to develop an attack of hypoglycemia.
0. S. SHCHEGLOVA, doctor
Usually, provided that the child is under the supervision of a doctor and diet, attacks of ketogenic hypoglycemia stop by puberty.
Hypoglycemia is a condition that develops with a sharp drop in blood sugar levels, when the supply of glucose and oxygen to the brain is disrupted and, as a result, a deep inhibition of higher nervous activity occurs.
Hypoglycemic syndrome occurs in children quite often, sometimes as "comorbid" with various endocrine, neurological and other diseases. And sometimes it develops in quite healthy children as a result of irregular, unbalanced nutrition, emotional or physical overstrain, or due to hereditary characteristics of the body.
Regardless of the causes of hypoglycemia, it always manifests itself more or less typically. The child is excited, irritable or, conversely, drowsy and apathetic, pale, has moist skin, dilated pupils, chills, and feels a strong sense of hunger.
If you show him in this condition to a doctor, he will find tachycardia and possibly high blood pressure.
In order to find out the exact diagnosis and establish that the child has hypoglycemia, laboratory tests are needed. And they are carried out during an attack. Blood glucose levels are usually less than 2.2 mmol/L.
Hypoglycemia is dangerous because it leads to changes in brain tissue. Prolonged disruption of the energy supply of the brain during hypoglycemia causes severe headache, dizziness, it is difficult for the child to concentrate, there are even short-term fainting, convulsions.
With repeated attacks, the sensitivity of brain cells to a decrease in blood glucose levels increases, and even short-term hypoglycemic states can affect both the mental and physical development of the child.
Many symptoms similar to those of hypoglycemia - sweating, heart palpitations, fatigue - can be due to completely different reasons.
Parents sometimes do not realize the nature of such a child's ailment and do not attach serious importance to it.
Meanwhile, hypoglycemia in young children is very dangerous, because at an early age, nerve cells are especially sensitive to a sharp change in sugar levels, and metabolic disorders can lead to serious damage to the central nervous system.
Such a child, of course, should be under the supervision of an endocrinologist. I want to give you some advice on how to help him during an attack, what diet to follow for preventive purposes, and so on.
Hypoglycemia occurs in children most often for two reasons.
The first is ketonemia, or acetonemia, that is, the appearance in the blood of ketone bodies - acetone, acetoacetic acid, beta-aminobutyric acid.
Ketone bodies are formed in the liver from fats with a lack of enzymes involved in their metabolism. Probably, many parents paid attention to the smell of acetone periodically appearing from the mouth of a sick child.
The toxic effect of acetone on the nervous system is very similar to the effect of alcohol: lethargy, anxiety, headache, dizziness, drowsiness, nausea, vomiting, sometimes loss of consciousness.
If you find all these symptoms in your child, plus the smell of acetone from the mouth, immediately, even before the doctor arrives, rinse his stomach with a soda solution (it is best to use Borjomi, Slavyanovskaya or Moscow mineral water for this, or just a solution of baking soda - a teaspoon in a glass of water ).
Make him drink at least three glasses and try to induce a gag reflex.
Also, as a first aid, let him drink a few sips of a starch solution (very well mixed, in suspension - only no more than 1 tablespoon per glass of water).
Three times during the day, give him suppositories with sodium bicarbonate, continue to give a little alkaline drink, preferably alkaline mineral water, but not with the aim of inducing vomiting, but in small portions.
Give honey one teaspoonful - 4 times a day, glutamic acid tablet 3-4 times a day.
After an attack, tests for the presence of ketone bodies in the urine will help control the condition of a child with ketogenic hypoglycemia; acetone is excreted from the body and with air, through the lungs, and with urine.
The appearance of ketone bodies in the urine is a harbinger of an attack, a signal that it can occur even after a few hours.
Treatment and prevention of such hypoglycemia is primarily diet. The child's menu should not contain animal fats - only vegetable fats, also exclude fatty meats, refined sugar.
He needs cottage cheese, boiled fish and boiled meat, vegetables and fruits, except for raisins, bananas, melons, grapes, sweet pears. Fractional nutrition - 67 times a day.
The second reason for the occurrence of hypoglycemia in children is intolerance or hypersensitivity to the leucine amino acid, one of the components of the protein. Leucine hypoglycemia is an innate metabolic feature.
It manifests itself at a very early age with attacks that usually occur after eating a meal high in leucine. The baby's condition is the same as with ketogenic hypoglycemia (only, of course, there is no smell of acetone), sometimes diarrhea and abdominal pain are added.
First aid: 1-2 dessert spoons of honey, any sweet jam.
With leucine hypoglycemia, as with ketogenic hypoglycemia, the main treatment is diet. But it is much more difficult to comply with it, because it is necessary to limit the protein needed by the growing child's body as much as possible.
It is necessary to exclude milk, eggs - they contain a particularly high content of leucine. Doctors had to observe severe seizures - convulsions, confusion - after the child ate just one egg.
It is necessary to refuse from fish, nuts, peas, pasta. In order to help parents figure out how and what to feed their child, I will give a table of the leucine content in various foods.
CONTENT OF LEUCINE IN PRODUCTS
(g per 100 g of product)
| Women's milk | 0,108 |
| cow's milk | 2,278 |
| Kefir | 0,263 |
| Cottage cheese | 0,924 |
| Egg | 1,130 |
| Beef | 1,730 |
| chickens | 1,620 |
| beef liver | 1,543 |
| Cod | 1,222 |
| Rice | 1,008 |
| Semolina | 0,364 |
| buckwheat | 0,702 |
| millet | 1,040 |
| barley | 0,584 |
| Peas | 1,204 |
| Wheat flour | 0,567 |
| Pasta | 0,690 |
| Rye bread | 0,275 |
| wheat | 0,550 |
| Biscuit | 0,357 |
| Potato | 0,107 |
| Carrot | 0,061 |
| White cabbage | 0,059 |
| Tomatoes | 0,022 |
| oranges | 0,019 |
| Lemons | 0,013 |
| Apple juice | 0,015 |
| orange | 0,15 |
The table shows that the least leucine is in vegetables, semolina and pearl barley, and from protein products - in cottage cheese.
- a pathology consisting in a significant decrease in the concentration of glucose in the blood.
If the level of this substance does not reach 2.2 mmol / l, serious diseases can develop, leading to a significant functional deterioration and even death.
Hypoglycemia is especially dangerous in children, due to the fact that in childhood there is an active growth, development and formation of the body. What are the main causes of hypoglycemia in children, why is it dangerous and how is it treated?
Causes
Predictions for the course of this disease largely depend on whether real reasons decrease in glucose levels in a child. In accordance with the causes, the treatment necessary for this disease is also being developed.
Quite often, hypoglycemia is a symptom of problems in the endocrine system of the child, in particular, due to improper functioning of the adrenal glands.
After all, one of their main functions is the synthesis of special hormones that have a complex effect on the body, protecting it from an excessive drop in glucose levels. These steroid-type enzymes promote the production of glucose in the liver, inhibit the absorption of this substance by the cells of peripheral tissues, and also reduce the activity of hormones involved in glycolysis.
The next reason for this phenomenon, especially in infants, may be heredity. Almost all children of a diabetic woman have. This is due to the peculiarities of the hormonal metabolism of the fetus and the influence of the mother's improper metabolism on the development of the child and the formation of his body.
Also, hypoglycemia in a child can manifest itself with hyperinsulinism - excessive production of insulin. There is primary and secondary hyperinsulinism.
Primary develops due to lesions of the pancreas, for example, insulinoma - a benign formation, or carcinoma - pancreatic cancer. In practice, insulinoma is more common, which is quite well amenable to surgical treatment.
Secondary hyperinsulinism is the result of the body's response to some irritant. The main reasons for its occurrence are:
Hypoglycemia in a child without diabetes can also begin as a result of malnutrition. If a growing and actively expending energy child's body does not receive enough of the necessary nutrients, the glucose level constantly drops.
After all, a child's body does not know how to "save" energy the way an adult does.
Irregular eating, lack of regimen can also cause low blood sugar in a child.
Finally, this disease can also be caused by heredity.
Hereditary hypoglycemia most often occurs in children under two years of age, and it mainly affects boys. Usually in this case we are talking about McCurry syndrome - an unpleasant feature of the enzyme that breaks down insulin - insulinase.
In children with this syndrome, insulinase decomposes insulin too slowly, as a result of which there is a lack of glucose in the body. This disease can be very serious consequences up to coma. Often with this disease, the occurrence of various brain lesions is noted.
The most dangerous for children with McCurry syndrome is the age of two to five years. Further, from the age of six, a deep remission usually occurs, characterized by the almost complete absence of symptoms of hypoglycemia.
Pancreas
The decrease in sugar levels may also be unrelated to the pancreas. Gastrointestinal disorders in a child can also lead to hypoglycemia. The fact is that in the stomach and intestines, the polysaccharides contained in the products are exposed to enzymes, mainly amylase and maltase. These substances break down polysaccharides to glucose, which is absorbed through the walls of the digestive organs.
In the event that the production of these enzymes is impaired, the body cannot process complex ones, respectively, glucose does not enter the body from food. This situation is typical for the defeat of the digestive system by some poisons, and may also occur due to the development of a tumor.
Quite often, the so-called "idiopathic" glycemia occurs, the causes of which doctors cannot establish.
Symptoms of the disease
Since hypoglycemia itself is very dangerous for the health and life of a child, and, in addition, can be caused by serious diseases, its early diagnosis is very important.
Regardless of the cause, hypoglycemia in children has the same symptoms.
At first, the child appears irritable and restless. The patient's mood changes sharply and often, he becomes uncontrollable. At the same time, apathy, indifference to everything and lethargy appear from time to time.
The skin with low sugar is whiter than usual. There is no blush, even after active games the blood does not rush to the face. Increased sweating appears, sleep and wakefulness disturbances are possible - during the day the child wants to sleep, and at night he is prone to active noisy games.
Over time, signs of damage to the nervous system appear - trembling of the limbs, numbness, muscle spasms, as well as digestive disorders, expressed in loose stools and vomiting. With a serious drop in glucose levels, a headache begins, body temperature is lower than 36.5 ° C. Further, arterial hypotension develops, and the pressure can drop very significantly.
Often, other symptoms appear, for example, temporary, decreased alertness, tachycardia.
Very often there is severe hunger and chills. In the event of a severe drop in sugar levels, dizziness and loss of consciousness are possible.
If there are several similar symptoms, or one is repeated for a long time, the visit to the doctor should in no case be postponed. Only a qualified specialist, after receiving the results of the relevant tests, is able to determine the disease and prescribe its treatment.
Early contact with a medical facility will help avoid negative impacts reduced level sugar on the child's brain and nervous system.
Methods of treatment
With severe hypoglycemia, accompanied by life-threatening symptoms for the child, treatment measures begin immediately, without waiting for the results of the tests.First of all, they practice oral administration of a ten percent glucose solution. If hypoglycemia has caused fainting, an intravenous infusion of a sterile glucose solution is performed.
Further, the appointment of antibiotic drugs is practiced, as well as funds that support the mechanism weakened by the disease. After carrying out these activities, based on the examination, the probable cause of the decrease in blood sugar levels is revealed, and subsequent treatment is prescribed depending on the causes of the disease.
In any case, therapy includes a special one, which requires five to six small meals a day, as well as strict adherence to the prescribed regimen. At the same time, measures are begun to treat the causes of hypoglycemia - drug treatment or surgery.
If the child is close to losing consciousness, and there are other signs of a hypoglycemic coma, you must independently give him a spoonful of sugar dissolved in a glass of boiled water.
Related videos
In this cartoon you will find answers to questions about what hypoglycemia is and what to do if it occurs:
In the case of early contact with doctors and the appointment of the correct treatment, a long-term remission may occur. If the underlying cause of the disease is identified and corrected, the child often does not suffer from the more dangerous low blood sugar, especially if dietary recommendations are followed.
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Hypoglycemia is a low concentration of glucose in the blood, the rate of which falls below 2.2 mmol / l. This disease is one of the causes of severe disorders of the central nervous system and even death in newborns. At any age, it requires accurate diagnosis and timely treatment. Future forecasts and consequences will depend largely on what caused such an undesirable pathology.
Causes of hypoglycemia in children
Just like that, hypoglycemic conditions in children do not occur. Provoking factors can be:
- disturbances in the work of the endocrine system, functions of the adrenal glands;
- if the mother is sick with diabetes, 90% of the born baby will have hypoglycemia;
- diseases of the nervous system;
- physical exercise;
- unbalanced diet;
- stress;
- impaired carbohydrate metabolism in the mother;
- hyperinsunilism;
- pathology of pregnancy;
- complications during childbirth;
- heredity.
Often there is hypoglycemia in premature babies born before the due date. It occurs in the first ten hours of life and is diagnosed in one out of every two low birth weight preterm infants. The disease is determined from the first days of the baby's life already in the hospital. However, just in case, parents need to know the first signs by which it can be recognized.
Symptoms of the disease
Usually, hypoglycemia in young children manifests itself in the same symptoms, regardless of the causes of its occurrence. The child has:
- irritability, anxiety, agitation, aggressiveness, uncontrollable behavior;
- all this can alternate with lethargy and apathy towards everything;
- pallor;
- heart rhythm disturbances;
- drowsiness during the day, and restless sleep at night;
- hunger;
- body temperature is less than 36.5°C;
- sweating;
- tremor (trembling due to muscle spasms), numbness, tingling of the extremities;
- liquid stool;
- arterial hypotension;
- vomiting;
- headaches.
Since such symptoms can be present not only with hypoglycemia, but also accompany other diseases, the diagnosis is confirmed by laboratory tests - blood sugar levels are measured. This must be done in a timely manner, since hypoglycemia at a young age is very dangerous: the younger the children, the more sensitive their nerve cells are to a drop in blood glucose levels. This causes damage to the central nervous system, mental retardation, epilepsy. If hypoglycemia is diagnosed in older children, its symptoms coincide with the signs of the disease in adults:
- increased anxiety;
- chills;
- pallor;
- loss of consciousness, fainting;
- blurred vision;
- convulsions;
- tachycardia;
- bouts of severe hunger;
- coordination disorders.
Hypoglycemia is dangerous at any age, as it causes severe headaches, leads to serious metabolic disorders, complete loss of coordination, frequent convulsions and fainting. The disease can affect the physical and mental development of the child in the future. Therefore, it is so important to determine the correct diagnosis in time and start treatment.
Treatment of childhood hypoglycemia
Since such a disease is often fatal, emergency care is carried out for hypoglycemia in children, even if it is not possible to measure blood glucose levels. She suggests:
- ingestion of a ten percent solution of glucose or sucrose, which each parent can easily prepare at home: for this you need to dissolve one teaspoon of granulated sugar in 50 ml of water;
- if the baby is already unconscious or has too frequent convulsions, intravenous injections of sterile ten percent glucose are given;
- antibiotics are prescribed;
- a specially designed menu is recommended, feeding should be done in small but frequent portions: foods should be carbohydrate-containing - this will allow glucose to enter the bloodstream gradually, without serious metabolic disturbances;
- an older child should always have sweets in his pocket, sweet fruits, a bag of cookies in his bag.
To reduce the mortality of babies suffering from hypoglycemia, they need individual care, timely methods of work, which include not only the treatment of the disease, but also its prevention.
Hypoglycemia is a pathology associated with a decrease in blood glucose levels, which becomes unable to provide brain cells. One of the most serious complications in diabetes mellitus is hypoglycemic syndrome, which can lead to a pessimistic outcome. Hypoglycemia in children is not a rare phenomenon, most often manifested at night or early in the morning. Diseases of the endocrine, nervous and other systems can cause this pathology. An unbalanced diet, stress and physical overexertion can cause hypoglycemia even in healthy people. The consequences of hypoglycemia most often become disturbances in the work of the central nervous system, in newborns a fatal outcome is possible. A child at any age requires timely diagnosis and treatment. Forecasts for the future and the consequences directly depend on the causes of this pathology.
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Severity
Hypoglycemia is characterized by a positive reaction to intravenous glucose. To stop the hypoglycemic state, the child needs an urgent increase in blood glucose levels. Doses must be correlated with the severity of the hypoglycemic syndrome.
| Severity | Signs and symptoms | Opportunity to help | Treatment |
| Mild hypoglycemia (1st degree) | Increased appetite, pallor of the skin, tremor, increased sweating, restless sleep, irritability. | Children of conscious age are aware of the appearance of the disease and try to overcome it. A young child (up to six years old) does not understand his condition. | Carbohydrates in the amount of 10-20 g (glucose tablets, juice or sweet tea). |
| Hypoglycemia of the second degree (moderate severity) | Pain in the head and abdomen, a sharp change in behavior (the child becomes capricious or aggressive), weakness, the skin turns pale, sweating increases, vision and speech are disturbed. | The child cannot overcome the disease on his own. They need help from adults. Children can drink carbohydrates. | Take 10-20 g of glucose in combination with a meal, which must include bread. |
| Hypoglycemia of the third degree (severe) | Weakness, disorientation, seizures and fainting. | The condition is most often unconscious or comatose, convulsions often occur. The child needs urgent administration of glucagon or glucose. | Glucagon (intramuscularly, alone):
|
Kinds
| With acidosis |
|
| Leucine |
|
Causes
The following factors can serve as the causes of the hypoglycemic state:
- malfunctions of the endocrine system and adrenal functions;
- diabetes mellitus in the mother in 90% of cases causes hypoglycemia in the child;
- malfunctions of the nervous system;
- physical stress;
- malnutrition;
- stress;
- violation of the metabolism of carbohydrates in the mother;
- hyperinsunilism;
- pathologies that manifest themselves during pregnancy;
- complications during childbirth;
- heredity.
Hypoglycemia often manifests itself in children born before the due date. It can be diagnosed within the first ten hours of life.
As practice shows, hypoglycemia can be observed in fifty percent of cases of low birth weight children.
Symptoms of hypoglycemia in children
Hypoglycemia in young children is most often manifested by the following symptoms, which does not depend on the causes of its occurrence:
- the child becomes irritable, agitated, restless, aggressive, his behavior is almost impossible to control;
- at the same time, lethargy and apathy towards everything may appear;
- the skin turns pale;
- heart rhythm is disturbed;
- there is drowsiness during the day, and at night the dream becomes restless;
- there is a feeling of hunger;
- body temperature drops below 36.5 degrees;
- increased sweating;
- tremor, numbness, tingling of the extremities;
- diarrhea;
- arterial hypotension;
- vomit;
- headaches.
Similar symptoms may appear with other diseases. Laboratory research(measurement of blood sugar levels) can confirm the diagnosis.
Hypoglycemia in a 2-year-old child is very dangerous (this is due to the sensitivity of nerve cells to blood glucose levels), so tests should be taken immediately.
Untimely intervention can lead to damage to the central nervous system, mental retardation and epilepsy. In large children and adults, the symptoms of hypoglycemia coincide and are expressed as follows:
- the appearance of a feeling of increased anxiety;
- chills;
- pallor of the skin;
- loss of consciousness, fainting;
- vision deteriorates;
- inability to concentrate;
- the appearance of seizures;
- tachycardia;
- there is an acute feeling of hunger;
- impaired coordination of movements.
The consequences of hypoglycemia can be severe headaches, severe metabolic disorders, complete loss of coordination, frequent convulsions and fainting.
This pathology is dangerous for children at any age, as it can affect the physical and mental development of the child. From all this it follows that it is important to determine the diagnosis as early as possible and begin treatment.
Differential Diagnosis
Failure to provide the patient with timely assistance threatens to turn hypoglycemia into a hypoglycemic coma, which inhibits higher nervous activity, manifesting itself as a lack of perception and an adequate response to external stimuli. If the patient is being treated with insulin, which does not bring him out of an unconscious state, differential diagnosis is necessary:
| Symptoms and data associated with test results | Hypoglycemic coma | Ketoacidotic coma |
| Development opportunity | Instantly, within minutes. | Long enough, for several days. |
| Feeling thirsty and frequent urination | None. | Expressed. |
| Hunger | Strongly expressed. | Increased appetite is replaced by a state of anorexia. |
| Nausea, vomiting | In young children with pathology. | permanent manifestation. |
| Condition of the skin | Sweat emerges. | Dryness. |
| muscles | Hypertonicity, trismus, convulsions. | Hypertonicity, in later stages, seizures may occur. |
| Tone of the eyeballs | Normal. | Short. |
| Pupils | Enlarged. | Enlarged, in rare cases narrow. |
| Breath | Rivne. | Sparse and noisy with the smell of acetone. |
| Blood sugar | Short. | Upgraded. |
| The presence of acetone in the urine | May be present. | Present. |
| Sugar content in urine | Less than 1%. | More than 3%. |
Treatment
Hypoglycemia in children requires emergency care, as such a disease can be fatal. Treatment for childhood hypoglycemia involves the following:
- It is necessary to drink a ten percent solution of glucose or sucrose, which every adult can do (for this you need to mix one teaspoon of sugar with 50 ml of water).
- An intravenous injection of sterile 10% glucose is necessary if the child is unconscious or has frequent convulsions.
- Taking antibiotics.
- The doctor develops a special menu that must be followed. Feeding should be carried out in small portions 6-7 times a day. It is worth giving preference to carbohydrate-containing products, which will ensure a gradual intake of glucose into the body and will not disrupt metabolic processes.
- An older child should always have candy, fruit, or a package of cookies with them.
Symptoms of hypoglycemia
are tremor, headache and impaired consciousness.
From here, you will be able to learn the basics and treatments for hypoglycemia. Symptoms and signs of reactive hypoglycemia are listed here. Treatment of the disease and its timely prevention will help in reducing the death rate in babies who suffer from hypoglycemia. Such children need constant care and timely intervention.
Hypoglycemic state is called too low (less than 4 mmol / liter) blood glucose level in a child. Is this condition normal in children or is it a sign of a disease? How to determine it and how to help children with hypoglycemia?
In a newborn baby, the cause of a hypoglycemic state may be maternal diabetes during pregnancy. During gestation, the baby got more glucose, which stimulated the production of more insulin in the baby's body. During childbirth, glucose ceases to enter the body of the crumbs, and insulin, which has been developed in the newborn, provokes a sharp drop in blood glucose levels. You can prevent such hypoglycemia by controlling the blood sugar level of the expectant mother. If hypoglycemia has developed, a glucose solution is administered intravenously to the baby.
A sharp decrease in sugar in the body of a child can be provoked by excessive mental or physical stress, as well as skipping meals. Also, this condition may be due to the intake of certain medications.
Low glucose can be a disease, or it can simply be triggered by some factors.
If we consider diseases, then hypoglycemia is most often one of the symptoms of type 1 diabetes in children, although it can also occur in type 2 diabetes, which develops in adolescents. An attack of a sharp decrease in glucose in the bloodstream in such diseases is facilitated by malnutrition, an incorrectly selected dosage of insulin, the occurrence of concomitant diseases, intense physical or mental work. Other diseases that can lead to hypoglycemia include severe somatic pathologies, tumors that produce insulin, dysfunction of the hormonal system (the work of the pituitary and adrenal glands).
Symptoms
With hypoglycemia in children, the following symptoms appear:
- sweating;
- Nervousness;
- Shiver;
- Irritability;
- Complaints of severe hunger;
- Shaky gait;
- Drowsiness;
- Fatigue;
- Dizziness;
- slurred speech;
- Apathy;
- The appearance of a feeling of anxiety;
- Feeling of numbness and tingling in the limbs;
- pale skin;
- Heart palpitations;
- Nausea;
- Headache;
- Decreased concentration.
Very young children with hypoglycemia begin to act up or, on the contrary, become drowsy or lethargic. They may refuse food and even sweets.
With the above symptoms, the child must be shown to the doctor.
- The type of hypoglycemia in newborn babies is called gestational.
- Hypoglycemia that develops suddenly in children in the absence of diabetes mellitus is called reactive.
The severity of hypoglycemia is:
- light (the child is able to eat something sweet and help himself with this);
- severe (requires injection of glucose and glucagon).
Hypoglycemia in diabetes mellitus
When a child has diabetes, there is always a risk of developing hypoglycemia, which occurs when there is an excess of insulin and a lack of glucose in the blood. A child who has frequent bouts of low blood sugar while on insulin should be seen by a doctor to change the treatment regimen.
Diagnostics
In the detection of hypoglycemia, the main attention is paid to the clinic and the blood test for sugar.
Of particular danger during attacks of glycemia is the loss of consciousness and the risk of developing coma. That is why being able to quickly diagnose such a condition is very important, especially if the child has diabetes.
Remember about possible complications and at the first symptoms, call an ambulance
In most hypoglycemic conditions, a quick improvement occurs after eating a carbohydrate food, such as candy (preferably without fat, as they slow down the absorption of sugar) or juice. Also, the child can be helped with glucose preparations, especially if an attack of hypoglycemia caused a loss of consciousness. Then the child should eat normally so that the glucose level stabilizes. In severe cases, the introduction of a glucose solution directly into the child's bloodstream is indicated. Glucagon is also used in the treatment of hypoglycemia. It is a hormone that acts opposite to insulin. Its injection increases blood sugar levels.
To replenish the level of glucose, the child should always give sweets with him. Tips
If a child has diabetes and is being treated with insulin, parents should prepare a glucagon kit and have it with them at all times. Also, be sure to carry sugary foods that can quickly raise your glucose levels.
If a child goes to school, a glucagon kit and sweets should be kept with him at all times during schooling, and teachers should be warned on how to deal with hypoglycemia.
Glucose is a very important metabolite for the human body. It is thanks to this carbohydrate that the brain cells, as well as other tissues of the body, are fed. The constancy of the internal environment, the proper functioning of the central nervous system and the well-being of both an adult and a child depend on the concentration of glucose in the blood. Hypoglycemia in children is a pathological condition in which the concentration of glucose in the blood plasma decreases below the minimum acceptable level, which leads to the development of certain symptoms, up to the onset of coma.
Each parent should understand that a large number of episodes when the child is ill, he has weakness, sweating may be due to low blood sugar. Unlike intoxication and malaise with infections, vegetative reactions, with hypoglycemia, such symptoms can be fatal for a small patient.
Signs and symptoms of low glucose levels in a child's body should be known to adults, since not only his health, but often his life will depend on the speed of first aid and the delivery of a small patient to the hospital.
Causes and mechanisms of development
Normally, a decrease in glucose levels can be observed briefly during periods of hunger, increased exercise or sleep. However, the body's compensatory reserves are able to make up for such a shortage of carbohydrates in plasma in a timely manner. Prolonged decrease in blood sugar concentration and causes the corresponding symptoms. The causes of hypoglycemia in children are as follows:
- Insulin overdose in diabetic children. This is usually the most common and common cause of hypoglycemia. The fact is that in diabetes, due to a lack of the hormone insulin, an increase in plasma glucose levels occurs. The introduction of such a hormone subcutaneously allows you to stop the symptoms of diabetes and prevent the development of various complications. But in some situations, when after a dose of insulin the child forgets to eat or has a poor appetite, the blood sugar level drops sharply.
- Incorrect administration of an additional dose of insulin. Quite often, children confuse the types of insulin (short-acting or long-acting) or incorrectly calculate additional doses after they have eaten sweets.
- Increased exercise stress and depletion of the body. In such situations, the child's glucose level may decrease due to the general depletion of carbohydrates in the body and a decrease in the rate of metabolic processes.
- Infectious diseases and food poisoning. Severe infection and malnutrition can also lead to hypoglycemia in a child.
- Somatic diseases that reduce the function of the liver and kidneys and affect the overall metabolism in the body of children.
- Teenager alcohol consumption.
When the amount of glucose in the blood decreases, less carbohydrates also enter the tissues and cells of the body. However, the energy needs of, for example, nerve cells are not reduced. Over time, this leads to the depletion of the energy reserves of cells and tissues, which leads to a decrease in their functional activity. In the case of the central nervous system, this can lead to inhibition of the function of the cerebral cortex and the development of coma.
It is important for parents of children, especially those with diabetes, to understand that the causes that contribute to the occurrence of hypoglycemia can lead to the development of such a condition at any time, even with a small mistake or oversight in insulin treatment.
Symptoms and signs of a hypoglycemic state
Unfortunately, not all adults can adequately assess and recognize the signs of a decrease in a child's blood sugar level. Very often, children themselves do not understand the danger of such a condition and cannot explain to strangers that they have diabetes. Therefore, it is important to recognize the following symptoms of hypoglycemia in children:
- Irritability, headache and unstable mood, bouts of fun. In young children, only a change in the activity of behavior can be reliably noted.
- The feeling of hunger and the desire to eat, which can even cause strange behavior. So, the child will try to get food in all ways (sometimes the most unpredictable).
- Sweating to the point that clothes and bed become wet. There is also an excess of saliva production.
- Trembling of hands and fingers.
- Tachycardia (fast heart rate) and shortness of breath.
- Increasing the tone of the muscles of the limbs.
- Seizures that may resemble epilepsy.
With severe hypoglycemia, the symptoms of this condition begin to progressively increase, up to the loss of consciousness in the child and the onset of coma.
The difficulty in recognizing such a condition in children by adults who have never been interested in diabetes is that the signs of hypoglycemia, when a coma or convulsive seizure has not yet developed, very much resemble many other childhood pathologies. Convulsions can be perceived as an epileptic seizure, changes in behavior and mood are attributed to capriciousness, sweating - to the peculiarities of the microclimate of the room, etc.
Any changes in the behavior of a child with a diagnosis of "Diabetes mellitus", which are immediately evident in the presence of concomitant symptoms of hypoglycemia - an occasion to urgently measure the level of sugar in the blood.
Diagnostics
In practice, the diagnosis of hypoglycemia in children is carried out initially by assessing the symptoms in a small patient, and then by measuring blood sugar.
Difficulty in the primary diagnosis, which is carried out by the ambulance team, can be made by loss of consciousness and the development of coma. Then the doctor needs to quickly determine the likely type of diabetic coma, the degree of depression of consciousness and decide on the tactics of providing medical care.
The appearance of convulsions, which must be differentiated from epilepsy or a seizure on the background high temperature, can change the priorities in diagnosis and treatment at the primary stage.
Hypoglycemia in young children is detected by measuring the level of blood sugar with a glucometer. This procedure can be carried out by both parents, if such a device is in the house (usually, in children with diabetes, its presence is mandatory), and emergency doctors.
It is noted that a slight decrease in glucose levels (up to about 2.7 mmol / l) leads to the initial clinical manifestations of the pathological condition, a decrease to a level of 1.7 mmol / l leads to clear signs of low blood glucose. Even lower blood sugar levels are usually accompanied by loss of consciousness and coma.
If your doctor suspects a specific cause of low blood sugar, he will prescribe general analysis blood and urine to determine the type of inflammatory process and the general condition of the body. To evaluate the state of a function internal organs a biochemical blood test is prescribed, which makes it possible to identify renal and hepatic insufficiency - conditions that can provoke hypoglycemia.
Microbiological and serological studies are needed to more accurately determine the infection.
The occurrence of signs of hypoglycemia in a child is a reason to urgently call for emergency medical care or take the child to a medical facility, especially if the symptoms of this condition arose against the background of an overdose of insulin or a concomitant infectious or somatic disease.
Treatment and prevention of occurrence
Naturally, avoiding the development of hypoglycemia in any child is much easier than treating such a condition. Usually, a child with diabetes may experience temporary symptoms of the condition. This does not mean that you need to urgently seek medical help, especially if your blood counts have returned to normal. However, such phenomena indicate that there is some factor that contributes to a decrease in the child's blood sugar below the standards - a violation of the diet, a large dose of insulin, etc.
To prevent the development of hypoglycemia, you must follow these tips:
- Teach your child the correct and regular administration of insulin, as well as regular monitoring of blood sugar levels.
- Explain to the child the possible symptoms or manifestations of a decrease and increase in plasma glucose levels, as well as the necessary actions in this case (eat sweets, seek help from adults, etc.).
- Follow the diet and the principles of proper nutrition.
- Correct distribution of physical activity.
- Regularly consult with your doctor, according to the approved schedule of visits.
Treatment of hypoglycemia in children is carried out as follows:
- Force the child to eat or drink something sweet. It is necessary to explain to the baby that he should always have a few sweets in his pocket that he needs to eat when he feels certain symptoms (tell in advance which ones).
- An ambulance can introduce glucose solutions according to certain schemes to relieve the condition, but only after measuring blood sugar levels.
- The introduction of the hormone glucagon. It is carried out with a severe course of the condition, as well as with an overdose of insulin.
- Symptomatic treatment of comorbid conditions and diseases.
Thus, unlike hyperglycemic or other diabetic coma, hypoglycemia is less harmful to health and can be stopped more quickly. However, this is its danger - minor symptoms of pathology may simply not be noticed by parents or falsely perceived as symptoms of an infectious or somatic disease. The relief of hypoglycemia should be carried out only in a medical institution and under the supervision of a doctor, since this is how you can not only avoid the development of coma, but also provide proper medical care in time when such a condition develops in a child.
Hypoglycemia in children of primary and school age, as well as in newborns, is often observed. In the absence of control over the condition of the child and improper treatment, there is a risk of developing a life-threatening condition, hypoglycemic coma. Therefore, it is extremely important to know all the symptoms of pathology, as well as methods for the prevention and treatment of the disease.
The causes of hypoglycemia in children are both physical and psychological. At the same time, the etiology of the onset of the disease in newborns and children differs somewhat from the year of life.
In newborns
The main causes of hypoglycemia in newborns include the following factors:
- Deficiency of growth hormones, cortisol, glucagon and tuitarism;
- Decreased sensitivity to adrenocorticotropic hormone (ACTH);
- Hyperinsulinism provoked by Beckwith-Wiedemann syndrome;
- Hyperplasia or adenoma of endocrine cells, islets of Langerhans, which contribute to the production of hormones;
- Nesidioblastosis;
- Congenital pathologies of amino acid synthesis, which include the disease maple syrup, tyrosinemia, propylonic and methylmalonic acidemia;
- Violations of the oxidation of fatty acids;
- Pathologies of the liver, galactosemia, deficiency of fructose-1,6-disphosphatase or glycogen synthetase;
- hypothermia;
- Intrauterine hypotrophy of the fetus;
- The presence of diabetes in the mother;
- The use of a large amount of glucose by the mother before childbirth;
- Maternal use of long-acting insulin preparations during pregnancy;
- The occurrence of mechanical asphyxia of the fetus during childbirth;
- Birth premature.
Often one of the reasons for the development of hypoglycemia in newborns are infectious processes suffered by the mother during pregnancy.
In children
The reasons for the development of hypoglycemia in children include such negative factors:
- genetic predisposition;
- The occurrence of pathological conditions during pregnancy and childbirth. It could be like infectious diseases mother, and complications in the process of birth;
- Metabolic disorders;
- Disruptions in the endocrine system;
- exorbitant physical activity;
- Psychological overstrain;
- Pathologies in the work of the nervous system;
- Incorrectly calculated doses of insulin.
The cause of the development of hypoglycemia in a child can also be malnutrition.
Species classification
A disease such as hypoglycemia can be classified according to several criteria at once:
- According to the principle of occurrence, the disease is hereditary or intrauterine, or acquired.
- According to the nature of the occurrence, depending on the meal. Pathology can occur on an empty stomach, or after eating.
- By severity.
However, the main classification of hypoglycemia in children occurs according to the degree of sensitivity of their organisms to individual enzymes and acids. According to this principle, the disease is divided into ketonemia and leucine hypoglycemia.
Ketonemia
In an infant or adult child, ketotic hypoglycemia, or acetonemia, occurs in the absence of certain enzymes capable of processing fats. Because of this, ketone bodies are formed in the patient's blood, which can disrupt the functioning of various organs and systems in the body.
Ketogenic hypoglycemia in babies is accompanied by impaired liver function and the release of a large amount of toxic acetone bodies. At the same time, a sick child often smells of acetone from the mouth, and often the baby suffers from indomitable vomiting.
Leucine
The clinic of leucine hypoglycemia in children is accompanied by increased sensitivity of patients to leucine acid. This pathology is considered congenital and manifests itself in babies at an early age. The child begins to feel bad almost immediately after eating protein foods.
Because of this feature, it is extremely important to correctly diagnose the pathology and choose the most suitable diet for the child.
Severity
Hypoglycemia has 3 degrees of severity:
- Light form. The patient begins to appear several symptoms of pathology at once. The child becomes lethargic or irritable, dizziness appears. The condition can be easily stopped on your own. To do this, you need to eat a product that contains simple carbohydrates, or take glucose tablets. To increase blood sugar levels by 0.22 mmol / l, 1 g of glucose is sufficient. After that, the child's condition returns to normal within 50-60 minutes.
- Severe form. The child has a fainting state, tremor, convulsions, loss of coordination and coherence of speech. The swallowing reflex may be inhibited. If the patient is able to swallow, he should be given sweetened water or some kind of high simple carbohydrate food in the form of sweets or chocolate. Gel-like glucose, which enters the blood in a short time, allows you to quickly stop the attack. It can be smeared on the gums of the child. For the preparation of sweet water, it is best to use dextrose.
- Hypoglycemic coma. The child is semi-conscious or unconscious. The intake of carbohydrates in the form of liquid or food is excluded. The patient needs emergency medical attention. It is important to inject a 40% glucose solution intravenously as quickly as possible, or inject glucagon intramuscularly. In the case when, after the manipulations, the child does not regain consciousness, he is given a subcutaneous injection of adrenaline.
In some cases, the pathology can proceed almost asymptomatically. Therefore, it is important to measure blood sugar levels several times a day with a glucometer.
Clinical manifestations
In newborns, the following main symptoms of the disease are distinguished:
- The appearance of circular floating movements of the eyeball;
- Nystagmus, or involuntary repeated trembling of the pupils;
- Loss of the oculocephalic reflex;
- A piercing, low, unemotional, high-pitched scream;
- Anorexia;
- Lack of communication skills;
- General weakness, sluggish movements;
- Tremor;
- Increased agitation and irritability.
Less often, pathology in newborns is accompanied by such symptoms:
- Increased muscle tone;
- convulsions;
- Apnea, or periodic cessation of breathing;
- Blue lips or whole body;
- Frequent fluctuations in body temperature of the baby;
- Rapid shallow breathing;
- tachyracdia;
- low blood pressure;
- pale skin;
- Increased sweating.
Symptoms of hypoglycemia in children older than 1 year include:
- Heart palpitations;
- causeless trembling;
- Dizziness;
- Apathy;
- General weakness;
- Nausea;
- Vomit;
- Pre-fainting state;
- causeless fear;
- increased sweating;
- Irritability;
- Constant strong feeling of hunger;
- Headache;
- Weak eyesight.
Sometimes the external manifestations of hypoglycemia in children resemble a condition alcohol intoxication. The child may lose coordination and walk staggering, and the condition is also accompanied by slurred and confused speech.
Diagnostic methods
The primary diagnosis of the disease is carried out by analyzing the symptoms present by the doctor. However, to confirm the diagnosis, the following laboratory tests are required:
- General blood sugar test;
- General blood test for fatty acids;
- Determination of the number of ketone bodies in the blood;
- The concentration of insulin in the blood.
Often, in order to make an accurate diagnosis and prescribe the correct treatment, a blood test is performed for the level of growth hormone, cortisol.
Methods of treatment
Treatment of hypoglycemia in a child involves the following measures:
- Maintaining the correct mode and method of nutrition;
- Limitation of intense physical activity;
- Protecting the child from severe stressful situations.
In the event of seizures, it is important to give the child first aid. First of all, it is necessary to measure the level of sugar in the patient's blood. After that, you should act depending on the severity of the child's condition. With the development of a severe or coma, it is necessary to call an ambulance. During a mild episode of hypoglycemia, the child should be given glucose, dextrose, or any sweet. In severe cases, waiting for the arrival of a doctor, it is necessary to introduce glucose or glucagon.
The role of diet in hypoglycemia
Compliance with certain nutritional rules for hypoglycemia will help maintain blood glucose levels at a normal level, as well as ensure the correct production of insulin by the body. So, with a pathology of this type, it is necessary to adhere to the following recommendations:
- Eat small meals every 2-3 hours;
- Minimize the amount of fat in food, as they interfere with the proper production of insulin;
- Be sure to eat foods rich in fiber. It allows you to slow down the process of converting sugar from complex carbohydrates;
- Eat foods that are high in starch. These include potatoes, peas and corn;
- Food should contain lean protein sources such as fish, chicken, and legumes.
During the day, it is important to eat foods that contain complex carbohydrates. These include greens, fruits and vegetables, as well as cereals and whole grain breads. Such food ensures the gradual replenishment of the body with glucose and the long-term maintenance of this indicator in the norm.
Prevention
Preventive measures for newborns consist of the following procedures:
- Ensuring long-term skin-to-skin contact between mother and newborn from the first minutes of birth;
- Frequent breastfeeding. Milk and colostrum have great benefits and value. Their composition is unique and cannot be replaced by any of the existing types of infant formula;
- Ensuring timely and nutritious nutrition;
- In the first 6 hours after birth, the baby is intravenously injected with special nutrient mixtures, as a supplement to breast milk;
- On the first day of life, the amount of breast milk drunk should be about 200 ml;
- If it is not possible to receive breast milk as the main food, specialized preparations are administered intravenously to the child, at the rate of 100 ml / kg of the newborn's weight.
Blood is taken from the newborn every 2-4 hours to determine the level of sugar.
For children of any age suffering from hypoglycemia, it is extremely important not to skip a single meal, and eat at least 4 times a day. Preventive measures also include:
- Meals should include plenty of fruits, breads and chocolates, which contribute to a rapid increase in blood sugar;
- Accurately calculate the dosage of insulin administered, correlating it with the amount of food eaten;
- Increase the dosage of insulin before exercise;
- Eat immediately after the administration of insulin preparations.
It is extremely important that a child with hypoglycemia always has some sweets in the form of sweets or a chocolate bar with him.
Forecast
The prognosis of the state of health of a child with hypoglycemia depends on the root cause of the development of the pathology, as well as the correctness and timeliness of treatment. So if the disease occurs as a result of prematurity, intrauterine infections, injuries at birth, as well as against the background of maternal diabetes, the prognosis is unfavorable. Quite often, these newborns later develop vision problems, including cataracts and optic nerve atrophy, as well as mental retardation.
With the development of hypoglycemia over the age of 1 year, in most cases the prognosis is favorable. However, with improper treatment, various comorbidities can be observed in the form of a lag in physical development, kidney dysfunction, hemorrhages in the lungs, visual impairment and the addition of infectious diseases.