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Hypoglycemia | Pediatric Diabetes | Patient Education | UC Davis Children's Hospital

Hypoglycemia (low blood glucose)

Symptoms of hypoglycemia in children

If your blood glucose is low, you may feel some of the following symptoms of hypoglycemia:

  • Shaking
  • Fast heartbeat
  • Sweating
  • Anxious
  • Dizziness
  • Hunger
  • Impaired vision
  • Weakness/fatigue
  • Headache
  • Nervous or upset

Common causes of low blood glucose

  • Too few carbohydrates
  • Too much insulin
  • Extra activity or exercise

Treating low blood glucose

You should treat blood glucose less than 70 mg/dL. Here’s how:

  1. Tell someone you feel low and test blood glucose.
  2. If blood glucose is 70 mg/dL or less, treat by eating or drinking fast-acting carbohydrate. (Refer to table in “Pediatric Diabetes Low Blood Glucose Treatment” handout for correct amount of fast-acting carbohydrate based on age).
  3. If blood glucose is 50 mg/dL or less, take DOUBLE the amount of fast-acting carbohydrate.
  4. Wait 15 minutes then re-check blood glucose. Repeat step 2 if blood glucose is 70 mg/dL or less.

Never give food to a person who is unconscious/unresponsive (will not wake up / does not respond) from hypoglycemia. If the person is unconscious/ unresponsive, give Baqsimi or Glucagon and call 9-1-1.

Pediatric diabetes low blood glucose treatment

Fast-acting carbohydrates for low blood glucose (less than 70mg/dL) based on age:

Age Carbohydrate
(grams)		 Juice
(ounces)		 Sugar*
(number of teaspoons,
cubes or packets)		 Glucose tabs
Younger than 16 months 4 1 1
16 months to 6 years 8 2 2 2**
7 to 10 years 12 3 3 3
11 years and older 16 4 4 4

For blood glucose 50mg/dL or less, DOUBLE the amount of recommended treatment.

*Sugar can easily be dissolved in water

**Only give glucose tablets to children older than 4 years old who can safely chew and swallow tablets

These guidelines are recommendations for the treatment of hypoglycemia. Please consult with your endocrinologist as needed.

Glucagon

A person needs Glucagon when they are having a severely low blood glucose AND they are unresponsive or unconscious, having a seizure, and/or are unable to take fast-acting carbohydrate like juice, sugar, icing, or honey by mouth. You should always have Glucagon with you.

Directions for use:

  1. Remove the flip-off seal from the bottle of Glucagon. Wipe rubber stopper on the bottle with an alcohol swab.
  2. Remove the needle protector from the syringe and inject the entire contents of the syringe into the bottle of Remove the syringe from the bottle.
  3. Swirl bottle gently until Glucagon dissolves completely. The solution should be clear and water-like in consistency.
  4. The usual dose is 1 mg. For children weighing less than 44 lbs., give ½ mg (0.5 mg mark on syringe). There is no danger of overdose with Glucagon.
  5. Inject immediately into muscle: buttock, thigh, or arm.
  6. Glucagon may cause vomiting. Turn patient on his or her side to prevent choking.
  7. Call 9-1-1 immediately after giving Glucagon.
Glucagon
Glucagon is used when someone’s blood sugar is low AND the person is unresponsive and unable to take carbohydrate by mouth. You should always have Glucagon with you.

Nasal Glucagon: BAQSIMI
(for people ages 4 years and older)

BAQSIMI is a nasal glucagon (sprayed through the nose) that can be used to treat severe low blood glucose (hypoglycemia).

Directions for use

  1. Do not remove the shrink wrap until you are using BAQSIMI. Remove shrink wrap by pulling on the red stripe.
  2. Open the lid and remove the device from the tube.
  3. Hold the device between your fingers and thumb.
  4. Insert tip into one nostril until finger(s) touch the outside of the nose.
  5. Push plunger all the way in. Dose is complete when the green line disappears.

Note – each device contains one dose (one dose is 3 mg). This dose is the same for all people ages 4 years and above.

For a “how-to” video, visit the BAQSIMI site

After giving BAQSIMI

  • Call 9-1-1 right away.
  • Turn the person on their side.
  • If the person does not respond after 15 minutes, another dose may be given, if another device is available.
  • The person receiving BAQSIMI should eat as soon as possible. When they can safely swallow, give the person a fast-acting source of sugar.

Important information to know

  • Store at temperatures up to 86°F (30°C) in the shrink-wrapped tube provided. Do not refrigerate or freeze.
  • Do not remove the shrink wrap or open the tube until you are ready to use it.
  • Do not push the plunger or test BAQSIMI before you are ready to use it.
  • BAQSIMI contains 1 dose of glucagon nasal powder and cannot be reused.

For more information visit manufacturer’s website: www.baqsimi.com