Diabetic Insulin Reaction (Infant/Toddler)

Children with type 1 diabetes often get insulin shots (injections). If the insulin level is more than the body needs, this can result in low blood sugar (hypoglycemia). This condition is sometimes called a diabetic hypoglycemic reaction or insulin shock. A hypoglycemic reaction can happen if too much insulin is given. It can also occur if the child is more active than usual, eats too little, or is ill.

A hypoglycemic reaction happens quickly. Symptoms can include:

• Nightmares or waking up crying out
• Hunger, a stomachache, or upset stomach (nausea)
• Being shaky, sweaty, or pale
• Fast heart rate
• Being fussy or crying for no reason
• Feeling weak or tired
• Feeling anxious or confused.
• Acting giddy or angry
• Being clumsy
• In severe cases, a child may have a seizure, faint (lose consciousness), or go into a coma  

Home care

• To treat a hypoglycemic reaction, test your child’s blood sugar (if possible). Then give your child something to eat or drink that has 15 to 20 grams of fast-acting sugar. This is to raise the blood sugar level. Choose something you know is safe for your child to eat or drink. This could be:
• • Glucose gel (see package directions for serving size)
  • 5 to 6 ounces of regular soda such as cola
  • 4 ounces of fruit juice
  • 2 tablespoons of raisins
  • 1 tablespoon of honey  (if your child is at least 1 year old)
  • 7 to 8 pieces of gummy candy or hard candy

• If giving another source of fast-acting sugar, check the food label. Find the serving size needed to get at least 15 grams of sugar.
• Wait 15 minutes, then test your child’s blood sugar again. The blood sugar level may still be lower than the range recommended by your child’s provider. If this is the case, then give your child another 15 to 20 grams of fast-acting sugar. Repeat these steps until the child’s glucose level is 70 mg/dl or above. Call your child’s provider for advice, if needed. If blood sugar does not improve, call a healthcare provider right away.
• Once your child’s blood sugar level returns to normal, he or she should eat a snack or meal. This will keep the blood sugar in a safe range. 
• If your child has fainted, give a glucagon shot right away. Hypoglycemic reactions that  are not treated can affect brain development. A blood sugar test should be done 15 to 20 minutes after the shot is given. 

Prevention

• Check your child’s blood sugar level, as directed by the healthcare provider. Try to keep the blood sugar in a normal range. Check the blood sugar more often when your child is ill or very active.
• Make sure that your child eats healthy meals and snacks on a regular basis. It is important not to skip meals. Your child should eat a snack before active play.
• Keep a record of your child’s reactions. Include insulin given, activity level, and symptoms.
• Tell caregivers about your child’s condition and how to treat any reactions.
• Have your child wear a medical ID bracelet that identifies him or her as having diabetes.
• Call your child’s provider if you have any questions about how to care for your child. 

Follow-up

Follow up with your child’s healthcare provider, or as advised. Your child’s insulin dosage may need to be adjusted. Follow the provider’s instructions. They may also advise a different type of insulin or a glucagon injection kit. For example, some types of insulin can be given after a child has eaten (instead of before). This may help greatly in choosing the correct dose. 

Special note to parents

Hypoglycemia may occur, even when you do your best to prevent it. As advised by the healthcare provider, be prepared. Always carry with you a source of glucose that can be quickly and safely given, or a glucagon injection kit.

©2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. This information has been modified by your health care provider with permission from the publisher.