What It's Like To Have Type 1 Diabetes | UC San Diego Health [023991]

2025-07-26

Post Time: 2025-07-26

Managing diabetes in school-aged children presents unique challenges, especially when it comes to low blood sugar (hypoglycemia). Hypoglycemia can be scary, disruptive, and even dangerous if not addressed promptly. Understanding how to identify, treat, and prevent low blood sugar is crucial for parents, educators, and, most importantly, the children themselves. This article provides practical guidance for managing low blood sugar in school settings, ensuring the safety and well-being of children with diabetes.

Why Hypoglycemia is a Concern

Children with type 1 diabetes, and sometimes those with type 2, rely on insulin to regulate their blood glucose. Insulin doses, when not properly balanced with food intake and activity, can lead to hypoglycemia. In children, this is further complicated by factors like irregular eating habits, changes in activity levels during recess and gym class, and difficulties in recognizing early symptoms. Hypoglycemia can impair cognitive function, impacting concentration and learning, and severe cases can lead to seizures or loss of consciousness.

Understanding the Symptoms and Recognizing Low Blood Sugar

Recognizing the signs and symptoms of hypoglycemia is the first step in managing it effectively. Symptoms can vary from child to child and can be mild or severe. Educating children, parents, and school personnel on these symptoms is critical for early intervention.

Common Symptoms of Low Blood Sugar in Children

Symptom Category Specific Symptoms
Physical Symptoms Shaking, sweating, rapid heartbeat, pale skin, dizziness, hunger, headache, fatigue
Cognitive Symptoms Confusion, difficulty concentrating, irritability, clumsiness, trouble speaking
Emotional Symptoms Anxiety, nervousness, tearfulness
  • Early Detection is Key: Pay attention to subtle behavioral changes. A usually active child might become unusually quiet or sleepy. Teachers should be aware of the possibility of subtle changes in a child's learning behavior as well.
  • Individual Variability: It is crucial for parents and caregivers to work with their child's endocrinologist to develop an individual profile of the child's typical low blood sugar symptoms and how to respond accordingly.

Teaching Children to Identify Their Own Symptoms:

  • Age-Appropriate Explanations: Explain the symptoms using language a child can understand. "Your body might feel shaky like a leaf blowing in the wind," is easier for a young child to visualize than "experiencing tremors."
  • Role-Playing: Use role-playing to practice recognizing and responding to various low blood sugar scenarios. This helps children become more comfortable identifying their own feelings.
  • Encourage Open Communication: Foster an environment where children feel safe talking about how they are feeling without fear or embarrassment.

Step-by-Step Guide: Treating Low Blood Sugar at School

When low blood sugar is suspected, prompt treatment is essential. Schools must establish clear protocols and ensure all staff members involved are trained to administer treatment. Here is a step-by-step guide for managing low blood sugar at school:

  1. Confirmation (If Possible):

    • If a blood glucose meter is available and the child is able, use the meter to check the blood glucose level. A reading below 70 mg/dL is generally considered hypoglycemia.
    • However, do not delay treatment waiting for a test if symptoms are very obvious.

  2. Immediate Treatment:

    • Fast-Acting Carbohydrate: Provide 15 grams of fast-acting carbohydrates. Examples include:
      • 4-6 ounces of juice (regular, not diet)
      • 4-6 ounces of regular (not diet) soda
      • Glucose tablets (follow label instructions for a 15 gram dose)
      • Glucose gel (follow label instructions for a 15 gram dose)
      • Avoid sugary treats like candy bars due to their fat content, which can slow down the carbohydrate absorption.
    Fast-Acting Carbohydrate Approximate Amount for 15g
    Regular Juice 4-6 ounces
    Regular Soda 4-6 ounces
    Glucose Tablets Varies by brand (follow instructions)
    Glucose Gel Varies by brand (follow instructions)

  3. Wait 15 Minutes:

    • Allow 15 minutes for the fast-acting carbohydrates to raise blood sugar levels. Avoid giving additional fast-acting sugar or food before the waiting period ends.

  4. Recheck Blood Glucose (if meter available):

    • If available, recheck the child’s blood glucose after 15 minutes. If it remains below 70 mg/dL, repeat steps 2 and 3.

  5. Snack or Meal:

    • Once the child’s blood sugar is above 70 mg/dL and symptoms are improving, provide a meal or snack if it will be more than one hour before their next planned meal. This ensures blood sugar stays up. Good choices might be a piece of cheese and whole grain crackers or a peanut butter sandwich.

  6. Seek Medical Help:

    • If symptoms do not improve, or the child loses consciousness, administer glucagon (if trained), and call for emergency medical assistance immediately.
    • If the school has a nurse or medical personnel, have them attend to the student as well.

Important Considerations

  • Emergency Supplies: Schools should keep an easily accessible emergency kit that includes juice, glucose tablets or gel, a glucagon kit, and a blood glucose meter if one is required. The kit location should be known to teachers, school nurses, and office staff.
  • Glucagon: Glucagon is an injectable medication that can quickly raise blood glucose in an emergency situation. School staff must be trained in its use if they are responsible for a child who has been prescribed glucagon.
  • Communication: Establish a clear plan for communicating between parents and school staff. Parents should be immediately notified after a hypoglycemic incident, especially a severe one. Parents should also provide written documentation (from their child's healthcare team) of their child's individual hypoglycemia action plan for the school.

Preventive Strategies: Keeping Low Blood Sugar at Bay

Preventing hypoglycemia is always better than having to treat it. Schools, parents, and children must work together to implement preventive strategies. Here are some useful tips:

For Parents

  • Consistent Meal and Snack Schedule: Work with school staff to align the child’s meal and snack schedule with their insulin regimen. Regular, balanced meals and snacks will help avoid erratic changes in blood glucose levels.
  • Communicate with the School: Have frequent communication with the child's teachers and school nurse. Keep them up-to-date about any changes in insulin dosage, new routines, or changes to your child's medical information.
  • Provide Detailed Information: Share a detailed written diabetes management plan, developed with their child’s healthcare team, outlining how the child should be treated for hypoglycemia and what measures are in place for preventive strategies. Include information about typical hypoglycemia symptoms for their child.
  • Packing the Proper Supplies: Send your child to school with a daily supply of necessary items such as snacks, juice boxes, glucose meter with extra batteries, and glucagon as prescribed by their doctor.
  • Advocate for Your Child: Be a strong advocate for your child and ensure that the school is meeting all of their requirements.

For Schools

  • Diabetes Training for Staff: Provide regular training for all staff members on recognizing and managing low blood sugar. Make sure all teachers, staff in the cafeteria, bus drivers and athletic personnel receive regular updated training.
  • Establish Clear Protocols: Implement clear protocols for recognizing and responding to low blood sugar, including access to emergency supplies and staff members who are specifically trained.
  • Individualized Care Plans: Each child should have a personalized plan that is easily accessible to all who need it, developed in coordination with parents and the child’s healthcare team.
  • Open Communication: Encourage open communication among school staff, parents, and healthcare providers.
  • Accommodations for Activity Levels: Plan ahead for variations in the school day schedule, such as activity levels during gym or recess, with extra monitoring. Some students might need a small snack before a gym class.
  • Create a Supportive Environment: Foster a school environment where all children feel supported and that there are ways for them to have regular communication with a trusted adult and their medical care providers when needed.

For Children

  • Teach Self-Monitoring Skills: Encourage children to participate in managing their diabetes by checking their own blood sugar and being active participants in noticing symptoms.
  • Empower Self-Advocacy: Educate the child on how to tell an adult if they feel their blood sugar is low, when they need food or a glucose tab. Encourage children to feel comfortable asking for help or requesting treatment.
  • Understand their Body: As children learn about the changes in their body that come with low blood sugar they will be able to communicate better. Encourage their learning and communication.

Conclusion: Working Together to Manage Low Blood Sugar

Managing low blood sugar in school-aged children requires a comprehensive, collaborative effort involving parents, schools, and children. By understanding the symptoms, treatment, and preventive strategies outlined in this article, everyone involved can contribute to creating a safe and supportive environment where children with diabetes can thrive both academically and physically. The focus should be on providing the support and resources needed to keep children healthy, ensure learning time is not interrupted, and that no child is placed at higher risk of harm because of their diabetes. Regular communication, open dialogue, and a consistent plan of action are the most effective ways to help children with diabetes lead healthy, happy, and fulfilling lives.

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What It's Like to Have Type 1 Diabetes | UC San Diego Health
What It's Like To Have Type 1 Diabetes | UC San Diego Health [023991]