Recognizing and treating low blood sugars in children can be challenging, especially for younger kids who may not be able to communicate how they feel. Parents or caregivers can take these steps to manage hypos in children.

Low blood sugars can be especially challenging for children who may not always be able to treat the symptoms on their own without an adult’s help.

This is known as hypoglycemia. The American Diabetes Association (ADA) defines this as a blood sugar of 70 milligrams per deciliter (mg/dL) or lower. But that range can vary based on the child’s age.

Hypoglycemia symptoms can vary widely in children, meaning that some may experience more severe symptoms or none at all at different blood sugar levels.

Here’s how to spot low blood sugar and how to help treat it.

Hypoglycemia is sometimes called an “insulin reaction.”

Sometimes, young children can’t identify low blood sugar or tell you how they feel. Look for these common symptoms that a child’s blood sugar is too low:

  • shaking
  • dizziness
  • blurred vision
  • nausea
  • moodiness, irritability, or crying for no reason
  • pale skin
  • jerky movements
  • trouble paying attention
  • sudden changes in behavior
  • confusion
  • seizures

A blood sugar check will let you know for sure whether the problem is hypoglycemia. Because other problems can also cause these symptoms, call your doctor if you’re not sure or if giving your child fast-acting carbs doesn’t ease their symptoms.

Severe hypoglycemia

Very low blood sugar is considered an emergency that requires immediate medical care. The ADA defines this as 55 mg/dL or lower. But diabetes often varies, and it can be different for everyone.

Severe hypos can quickly become dangerous if not treated immediately. They may lead to serious health issues, such as:

  • seizures
  • coma
  • brain damage

Your child’s healthcare professional may also advise you to carry an emergency medication called glucagon, which treats severe hypoglycemia immediately.

The most likely cause is taking too much insulin or another blood sugar-lowering medication. Miscalculating a dose or using the wrong type of insulin can also cause blood sugar to drop.

Children can also get hypoglycemia from:

  • missing meals or eating later than usual
  • eating too little food
  • not counting carbohydrates correctly
  • exercising too much without eating enough
  • vomiting or having diarrhea
  • getting injured
  • taking sulfonylureas or other diabetes medications

To manage low blood sugar, give your child a food containing quick-absorbing sugar, like:

  • orange juice or another type of juice
  • cake icing
  • Skittles or other hard candies
  • 1/2 cup of sugar-sweetened soda
  • three to five glucose tablets

Ask your child’s healthcare team how much sugar to give, based on your child’s age and weight. It’s important to get their advice on this, since it’s specific to your child and their needs.

In general, the ADA notes that:

  • infants may need 6 grams (g) of sugar
  • small children may need 10 g of sugar
  • older children and teenagers may need less than 15 g of sugar, but it may vary

Use the Rule of 15

The ADA recommends using the rule of 15 (or 15-15 rule) for treating low blood sugar. This involves:

  • consuming 15 g of fast-acting carbs,
  • then waiting 15 minutes to check blood sugar, and
  • repeating as needed to get blood sugar levels back to 70 mg/dL or above

Young children may need less than 15 g of carbs, but the same logic applies. A child’s diabetes care team can help discuss how to manage hypoglycemia and what steps may be necessary at different low blood sugar levels.

Call your child’s healthcare professional if your child often gets hypoglycemia or if it’s often difficult to manage your child’s blood sugar levels. They may need to make a change to your child’s treatment plan.

Get emergency medical help right away if your child has severe hypoglycemia, which is a life threatening emergency. Call 911 or your local emergency number.

Signs of severe hypoglycemia include:

  • fainting
  • losing consciousness
  • seizures

Low blood sugar levels cause hypoglycemia. This can happen from taking too much insulin or another medication to lower the blood sugar.

Hypoglycemia in children with type 1 diabetes is common and treatable. It’s important to familiarize yourself with the symptoms of hypoglycemia so that you and your child can manage their blood sugar levels effectively. This will help them improve their well-being and avoid serious complications.