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Diabetes: prevention of further hypos (hypoglycemic reaction) DIABETES: PREVENTION OF FURTHER HYPOS (HYPOGLYCEMIC REACTION)
Check for possible causes of the hypo
If a severe hypo occurs, check the following possible causes:
1. Was all the diet taken, and at the right time?
2. Was the dose of insulin measured correctly?
3. Has there been extra physical activity that day leading to the burning up of more glucose in the body?
4. Has there been some digestive upset, perhaps with diarrhea or vomiting, leading to poor absorption of the food?
Check the diet. Check sugar for activity
If any of these factors has been the cause of the reaction, then prevention of further reactions should be possible by attention to the cause. Perhaps a review of the measurement of diet is needed, and a talk with the dietitian may be helpful. If extra activity was the cause, then the child should remember to take more sugar or other carbohydrates next time he has such activity. If it was due to a digestive upset, then substitution of emergency fluid feedings for the usual diet may lead to better absorption.
Does the insulin dose need reducing?
If none of the above factors was present, then it may be the insulin dose needs reduction. Have blood tests been low recently? You should discuss this with your doctor, but at all events a reduction of 2 to 4 units of insulin at a time is usually sufficient.
An occasional mild hypo is not harmful
If you can find no reason at all for the hypo reaction (and this is quite possible) then you may wish to discuss it with your doctor, but an occasional mild reaction does have to be expected and should not be a source of worry.
Just be sure that you and your child give as much attention to the details of the treatment regimen as possible.
Remember also that hypo reactions, though unpleasant and perhaps alarming, are not dangerous if treated promptly. With growth, maturity and experience they should occur less and less and perhaps be entirely preventable.
Glucagon
Glucagon has the opposite effect to insulin; it raises the glucose level in blood. Glucagon is given by injection.
Glucagon is a hormone which, like insulin, is normally produced in the pancreas. It has the opposite effect to insulin however, and it can release glucose from stores in the liver and thus raise the blood glucose level. It can be injected under the skin like insulin with an insulin syringe and needle, or using the syringe provided.
It is therefore a very useful material, as it can be used in children who have a severe hypo reaction if they are unable to take sugar by mouth.
Within 10 to 15 minutes a person with diabetes who has been unconscious or unable to swallow will usually return to consciousness so he can then take sugar by mouth. Parents can give this injection without trouble.
Give sugar after the glucagon
It is important to give sugar by mouth as soon as the child is able to take it, giving it the same way as for any severe insulin reaction.
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