Lows

The only emergency that could occur quickly is hypoglycemia or low blood sugar. This can occur if he gets more exercise than anticipated, does not eat as much as usual, receives too much insulin, is ill, or is stressed.

The warning signs of low blood sugar vary, but can include any of the following:

• Hunger
• Paleness
• Sweating
• Shaking
• Eyes that appear glassy, dilated ("big") pupils
• Personality changes such as crying or stubbornness, irritability, confusion
• Headaches
• Inattentiveness
• Drowsiness
• Weakness
• Speech and coordination changes

Kenny is pretty good about letting an adult know that he feels low. Specific signs for him are an indication of hunger or thirst, looking really tired, becoming irritable, or falling down a lot while playing.

Usually he will tell me that he "feels low" and I always check. Sometimes I will observe some of the above symptoms and check him. Most specifically, falling down while running around playing or irritable behaviour.

He is most likely to experience low blood sugar just before a meal or snack and during or after vigorous physical activity. This is not always the case though, we sometimes get surprised with a low blood sugar reading for unknown reasons.


If Kenny says that he feels low, do not leave him alone or make him walk too far to get to a place where he can be tested.

HOW TO TREAT:

**Always get Kenny to wash or wipe his hands and dry them well before using the glucose meter. If he has sugar on his fingers from a previous snack or low treatment, this may result in a high reading. If his hands are too wet, the meter might show an error. Pre-moistened hand wipes are kept with his meters.

When Kenny’s blood sugar is less than 4.0 mmol he needs to consume 10-15g of sugar immediately to bring his levels back into the normal range.  These are kept in Kenny’s Red Diabetes Bag or in his tummietote belt.  Some appropriate sugar sources include:

• Four Dex-4 Tablets
• Juice box
• ¾ cup regular pop
• Two rolls of rockets
• Other pre-measured candy

Give Kenny the sugar, check the time and re-test his blood sugar ten minutes after he has finished consuming the sugar.  He should sit and rest for these ten minutes (not by himself) to allow for proper absorption of the sugar.  If he is still low after ten minutes, repeat the above treatment.

If Kenny is low and it is close to a meal or snack time, he should eat right away after treatment. Call a parent for early pick up for lunch if it's close to lunch time. If there is still a lot of physical activity planned after a low treatment, give him his extra snack (a 15g carb serving and some protein).

**WHEN IN DOUBT TREAT**

 If there is ever a reason that Kenny cannot be tested but shows symptoms of low blood sugar, treat him anyway.

**SEVERE HYPOGLYCEMIA**

 IF KENNY LOSES CONSCIOUSNESS, IS UNABLE TO SWALLOW OR IS HAVING A SEIZURE: ROLL HIM ONTO HIS SIDE (in case he vomits), CALL 911, THEN CALL PARENTS.