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The Dangers of Hypoglycemia – New Educational Resources

April 18, 2019 Lisa Feierstein Diabetes Leave a comment   , , ,

One of the biggest fears of people living with Type 1 Diabetes (T1D) and their caregivers is a low blood sugar event, also known as hypoglycemia. While people with T1D may not recognize the signs of dropping blood sugar, most know how dangerous it can be if left unnoticed or untreated.

What is Hypoglycemia?

  • Low blood glucose levels – outside of your target range
  • Typically less than 70 mg/DL
  • Triggers your fight/flight response due to a release of adrenaline
  • If left untreated, may lead to seizure or coma.

What is Hypoglycemia Unawareness?

Diabetes Blood Glucose TestingHypoglycemia unawareness is a complication of T1D where the patient misses the typical symptoms of a blood sugar drop (palpitations, sweating, anxiety, etc.). When their body does not release adrenaline there are no warning symptoms and then they are at risk for life threatening complications.

Online Interactive Resource – Hypoglycemia Education

We recently came across a new educational resource about hypoglycemia from the ‘Diabetes Sisters.’ This online resource includes basic information about hypoglycemia as well as video-based and interactive learning, infographics and more. Topics include “What Does Hypoglycemia Feel Like?” and “How to Talk to Your Doctor About Hypoglycemia.”

Each topic includes videos, quick tips and a quiz to test what you’ve learned. Visit the website to test your knowledge and share with family and friends so that they can be familiar with the signs of low blood sugar and help you if needed. It is important that people with diabetes know the risks of hypoglycemia as part of your diabetes management plan.

Additional Resources

Diabetes Sisters – visit this online community to read stories of how others deal with the real life challenges of diabetes.

411 on the CGM

American Diabetes Association – Hypoglycemia (Low Blood Glucose)


New Recommendations from the ADA: Management of Type 1 Diabetes in Children and Adolescents

December 20, 2018 Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , , , ,

The American Diabetes Association recently shared an updated position statement on the management of type 1 diabetes in children and Adolescents. This statement is an update to their previous position statement issued in 2005. Their statement highlights the common sense idea that children are not just mini-adults. Treatment plans for children with Type 1 diabetes need to be tailored to both their current situation and their future growth and development.

The following areas were highlighted in the updated statement of recommendations for children and adolescents with Type 1 Diabetes (T1D):

  • Diagnosis of Diabetes
  • Blood Glucose Level Management
  • Lifestyle Considerations
  • Self-Management of Diabetes
  • Complications and Comorbidities
  • The Transition from Childhood to Adolescence and Adulthood

Diabetes Blood Glucose Testing

New Recommendations for Blood Glucose (BG) Management in Children and Adolescents

Most children’s T1D should be treated with insulin regimens with either multiple daily injections or via insulin pump therapy. Healthcare professionals should measure A1C levels of their non-adult patients at 3 month intervals. The target level of A1C should be 7.5 %. Patients or their caregivers should monitor BG levels multiple times a day, typically 6 to 10 times.

Medical devices such as insulin pumps and continuous glucose monitors (CGM) can be very helpful in the management of T1D. The ADA recommends that the CGM be considered in all children and adolescents, even though not using insulin pump therapy. Studies have found that compliant use such devices correlates with better BG control, lower A1C levels and reduction in hypoglycemic events.

Adjunctive Therapies for Children with T1D

One highlight in their recommendations between the management of type 1 diabetes in children versus adults is in regard to adjunctive therapies. They do not recommend the use of adjunctive therapies, such as the medication metformin in children. Clinical trials showed that despite the advantages of such therapies to help with weight loss or other diabetes comorbidities, there are more risks than benefits for children.

Check back next month for our follow-up blog talking about the unique behavioral aspects of managing diabetes in children and adolescents. We’ll focus on the challenges of self-management of their disease and other related health and wellness concerns.

Additional Resources

411 on CGM
Exercise for Children with Diabetes
ADA Position Statement


Exercise and Blood Sugar Control for Kids with Diabetes

February 22, 2018 Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , , , , , , , , , ,

There are many good reasons for anyone with diabetes to participate in a regular exercise program. But what are the important considerations about exercise and blood sugar control for kids with diabetes?

children-exercising-diabetes

Exercise can stabilize blood sugar levels and help maintain a healthy weight. Excess body fat prevents insulin from working to its full potential to control blood sugar. Another benefit of regular exercise is stress reduction and relaxation. Exercise is fun, especially when you are playing your favorite sport with your friends!

Preventing Low Blood Sugar – Hypoglycemia

Every diabetic knows the importance of planning in the successful management blood sugar. Regular blood sugar testing, or the use of a continuous glucose monitor, along with meal planning are all parts of comprehensive diabetes management plan. One consideration for active children, especially those participating in organized sports is the prevention of hypoglycemia.

Activities done for a long period of time, even at a moderate pace can cause the blood sugar levels to drop precipitously, even hours after the activity has ceased.

Keep coaches in the loop. They can assist with extra testing and have quick sugar snacks available, like fruit juices, hard candy, or honey. Coaches should know the signs of both low and high blood sugar, and keep handy instructions about what to do if either situation occurs.

Symptoms of Low Blood Sugar (hypoglycemia):Sweating, lightheadedness, shakiness, weakness, anxiety, hunger, headache, problems concentrating, and confusion

Symptoms of High Blood Sugar (hyperglycemia):Frequent urination, fatigue, increased thirst, blurred vision, and headache

Hyperglycemia and Dehydration

When your muscles work hard they signal for the body to release extra glycogen from storage in the liver. If this excess glucose is not needed, and the amount of insulin doesn’t match the blood glucose, hyperglycemia (too much blood sugar) can result.

Shorter intense activities – like sprinting or weight lifting may actually cause a rise in blood sugar. The body sees the energy expenditure uptick and releases stored glycogen from the liver. If the activity level is not maintained, the body can’t use the excess sugar and blood sugar levels go up.

Unfortunately the body tries to remove the excess glucose through increase urination – which can contribute to dehydration. As with all athletes, children with diabetes need to stay well hydrated during any physical activity. The excitement of competition can produce extra adrenaline, which can also raise blood sugar.

Planning is the Key

Your healthcare provider may recommend a change to insulin dosing on the days when your child has practice or a game where there will be a higher level of physical activity. Tracking blood sugar levels before, during and after activity can give valuable information to your child’s healthcare provider to adjust dosing schedules.

Get to know how your child’s body reacts to different kinds of activity. To prevent the worry of blood sugar swings consider adding a continuous glucose monitor (CGM) to your child’s diabetes management program. (link to 411 on CGM blog) A CGM will provide 24/7 updates on blood sugar levels and trending information.

A Lifetime of Fitness

Family Taking a WalkEveryone can appreciate the long-term benefits of fitness – improved functioning of your heart, lungs, and other vital body systems. Exercise enhances flexibility and increases muscle strength.

Even if your child does not play on a sports team you can still plan activities as a family to keep everyone moving. Ask your child to suggest activities for your family as they are much more likely to happily participate in activities that they already enjoy.

Additional Resources:

WebMD’s Safe Exercise Tip List for Children with Type 1 Diabetes

How to Exercise Safely with Type 1 Diabetes

The 411 on CGM


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