Category: Diabetes

Blood Sugar Balance

Human body requires energy, which comes from food. Sugars and starches, known as carbohydrates, are the most efficient energy sources. In the gut, they are broken down to glucose, which gets into the blood stream and is delivered to various organs and muscle. Blood glucose is often called blood sugar. The blood sugar concentration in healthy individuals varies from 60 – 90 mg/dL after fasting to not more than 140 – 150 mg/dL one hour after a meal. This is called a healthy blood sugar balance. It goes back to the baseline level 2 – 3 hours after a meal.

The blood sugar concentration is controlled by two hormones, glucagon and insulin. Both hormones are produced in the pancreas in response to changes in the blood sugar levels. During fasting, the decreasing blood sugar levels trigger secretion of glucagon by the pancreatic alpha cells and inhibit insulin production by the pancreatic beta cells. The increase of the blood sugar level after a meal stops glucagon production and promotes insulin secretion by the pancreatic beta cells. Therefore, glucagon and insulin are antagonists.
Glucagon stimulates breakdown of glycogen, a starch-like compound produced and stored in the liver, to glucose. If glycogen is depleted, glucagon triggers gluconeogenesis in liver cells. Gluconeogenesis is a process of glucose synthesis from the products of protein and fat digestion. Glucagon also stimulates fat breakdown in the adipose (fat) tissue. Insulin stimulates glucose uptake by all cells in the body, especially by muscle, liver, and adipose tissue. In the liver, insulin promotes synthesis of glycogen from glucose. Insulin also stimulates fat production and storage in the adipose tissue.
In summary, the blood glucose concentration is self-regulated. When it is too high, insulin is produced, and the excess of glucose is quickly absorbed and stored for later. When it is too low, glucagon is secreted, and the glucose is released to the blood stream.

The delicate and precise mechanism of the blood sugar maintenance is impaired in diabetes mellitus, a chronic metabolic disorder. Type 1 diabetes is a condition when the pancreatic beta cells stop producing insulin. Most type 2 diabetes patients produce at least some insulin, but their bodies have a reduced capacity to absorb glucose even in the presence of insulin. Diabetes of both types results in a significant (2 – 5-fold) in the bloodstream for hours and days. Disruption of the blood sugar regulation has multiple serious health consequences.

A very high (>400 mg/dL) blood sugar level might cause potentially fatal conditions, such as a coma and diabetic ketoacidosis. These conditions occur predominantly in patients with type 1 diabetes, when it is left untreated. However, even a moderate increase of the blood sugar levels, above 120 mg/dL after fasting and above 240 mg/dL after eating, which is typical for the early stages of type 2 diabetes, should not be left unchecked.
The most serious and consequential effect of a sustained increase of blood sugar is blood vessel damage. The latter can cause blindness because of retinal vessel destruction, heart attack and stroke due to atherosclerotic changes of the main arteries and brain blood vessels, and nephropathy because of the vessel damage in the kidneys.
Furthermore, high blood sugar triggers a vicious cycle of metabolic disruptions. Beta cells constantly exposed to the glucose levels similar or higher than those normally occurring for a short period of time after eating, are forced to produce more and more insulin. In a long term, insulin overproduction might lead to the beta cell damage. Muscle, liver, and adipose cells, exposed to elevated levels of insulin for the extended time periods deplete their capacity to respond to this hormone, insulin resistance worsens, and diabetes progresses.

The only way to avoid the long-term complications and life-threatening consequences of diabetes is to restore the blood sugar balance. For type 1 diabetes, insulin injected several times a day or delivered with an insulin pump, is the only therapeutic way to maintain the blood glucose reasonably close to its normal levels. The proper dose of insulin is calculated based on the amount of carbohydrates consumed with each meal to avoid a dangerously low blood sugar. For the patients with type 2 diabetes, manifested by the insulin resistance, rather by the lack of insulin production, there is a variety of approaches to control the blood glucose levels.
Exercise. This is the first line of defense against the damages caused by high blood sugar, or hyperglycemia. If you have too much “fuel” (sugar) in your blood, then aim to “burn” the excess.
Start with adding 15 minutes of any physical activity. Gardening, mopping the kitchen floor, going to a store two blocks away and back, or walking your dog will do. Just do something that makes you breathe a bit faster for a few minutes every day. Enjoy. Make it a part of your routine. Consider those minutes as a “me” time. Be consistent, and you will find yourself signing up for hikes and races in a few months.
Eating healthy without dieting. This is the second line of defense. There is not any specific diet or meal plan currently recommended for the patients with type 2 diabetes by medical professionals. Any culture- or religion-based restrictions, including vegan or vegetarian, can be accommodated for a person with diabetes. The common strategy for meal planning includes avoiding processed foods, including the nutrient-rich vegetables, seeds and nuts, and keeping in mind that some foods, consumed in large amounts, might cause a blood sugar spike even in a healthy individual, let alone the person with diabetes. They contain relatively high amounts of glucose or starches that are easily broken down to produce glucose. The examples of these foods are grapes, watermelon, bananas, white bread, corn, pasta, potatoes, and other sweet and starchy products. Soda, chips and candy are not mentioned here, because these are the processed foods that the medical professionals recommend limiting anyway.
Medications. For most people diagnosed with diabetes the diet and exercise regimen are not enough to maintain the blood sugar levels in a healthy range. There are several pills and shots that help to restore the broken mechanism of the blood sugar balance.
• Glucose suppressors are represented by biguanides, better known as metformin, a pill prescribed to most of the patients newly diagnosed with type 2 diabetes. It decreases glucose production in the liver and promotes glucose delivery from blood stream. Consider Metformin-like medications as insulin helpers and glucagon adversaries.
• DPP-4 inhibitors promote synthesis of insulin and decrease synthesis of glucagon by sustaining the increased levels of yet another group of hormones, incretins. These medications are often combined with metformin in one pill.
• GLP-1 receptor agonists also increase the level of incretins. These are injectable medications.
• Insulin secretagogues include sulfonylureas, meglitinides, and D-phenylalanine derivatives. They stimulate insulin production by pancreatic beta cells. Sulfonylureas can be used in combination with any other class of oral diabetic medications besides meglitinides.
• Insulin sensitizers, thiazolidinediones, improve glucose transport and decrease glucose production by liver.
• SGLT-2 inhibitors, gliflozins, prevent glucose re-absorption by kidneys, so the excess glucose is removed from the body with urine.
This list includes only the most commonly prescribed medications. You should discuss these and other options with a medical professional.

Diabetes does not have a cure yet. However, it is not a reason to give up. Medical professionals are working on an “artificial pancreas”, which is a combination of a continuous blood sugar monitor and an insulin pump, which will inject the right amount of insulin at a right time. There are more non-insulin medications for the type 2 diabetes patients in the pipeline. In the meantime, make sure to share this article on social media with your friends, post a link to it on your web site, and let’s get up and moving, keep in touch with the medical care provider, and make the healthy food choices!

Hypoglycemia In Children

Hypoglycemia is a condition that occurs when the level of blood sugar in the body is too low. According to the American Diabetes Association, a value of 70 mg / dL or lower is a sign of Hypoglycemia in children, who are under treatment for diabetes. In a healthy child, without diabetes, these values should be lower than 55 mg / dL to be considered hypoglycemia.

Generally, children with diabetes are more prone to hypoglycemia than a normal child. Symptoms of hypoglycemia in a child with diabetes is more common because the diabetic child abstains from consuming sugar, which may result in the reduction of blood sugar to a dangerous level.

In rare cases, a non-diabetic child can also fall victim to hypoglycemia. However, hypoglycemia in non-diabetic children is usually associated with a disease or malfunctioning organs such as Pancreas and Kidney.

Hypoglycemia is associated with a low level of sugar in the blood. The sugar inside our body is also known as Glucose, and glucose is required by the body and the brain to function properly.

Accordingly, it is important to maintain a healthy glucose level: not too high or too low. If hypoglycemia is not treated immediately, it can worsen quickly and deprive the brain of glucose. If you do not act soon, the child may feel confused and unable to handle the situation. In severe cases, the child may even lose consciousness, experience seizures or go into a coma.

Hypoglycemia can also occur if children do not consume enough nutrition as per their daily requirements. It can also affect weak children if they skip a meal or exercise more than usual if the child has diabetes.

As suggested, diabetic children are more prone to hypoglycemia compared to a normal child. If a child is taking medication to control or lower glucose level, they may inadvertently lower their glucose levels to a dangerous level.

Medicines for diabetes affect insulin levels, which is a hormone inside our bodies that regulate blood sugar levels. If a child is taking one of the diabetic medicines, the blood level inside their body can decrease in a very short span of time. If it decreases below 70mg / dL in a diabetic child, it is usually a sign of hypoglycemia.

In a non-diabetic child, the lowering of blood sugar may be related to many other factors. For instance, a lot of sweating after a rigorous exercise schedule can lead to lowering of sugar levels. In fact, problems with the pancreas and other body parts are also a major cause of low blood sugar in non-diabetic children.

A normal blood sugar range is between 99mg / dL and 70 mg / dL. Depending on the symptom, hypoglycemia can be mild, moderate, and severe. Here are some signs and symptoms of hypoglycemia when the glucose level reaches below 70mg / dL:

Mild: below 70 mg / dL

• An intense feeling of hunger
• Nervousness and tremors
• Perspiration

Moderate: below 55 mg / dL

• Dizziness
• Drowsiness
• Confusion
• Difficulty speaking
• A feeling of anxiety and weakness

Severe: below 35-40 mg / dL

• Seizures
• Loss of consciousness, coma

Hypoglycemia rarely occurs in children except those who are actively treated for Type 1 diabetes. Unlike adults, children should be looked after carefully because they are often not able to feel the warning signs. Under these conditions, doctors recommend supervising children while they are playing or when they’re engaged in activities requiring consistent energy. Recognizing the early signs of hypoglycemia in young children is an important aspect of controlling the disease, which can lead to long-term stability and cure.

Following are some examples of hypoglycemia symptoms in children with diabetes:

hypoglycemia in children headache
Children who are old enough to talk can complain of a headache, which is a potential sign of mild hypoglycemia. A young child may indicate that he feels “funny” or the child may provide other signals indicating a headache. For instance, young children may try to grab their head indicating problems with the vision.

Adults should not ignore these signs. If this happens, you can either check the glucose level or ask questions to take appropriate action based on the answers provided.

Not all episodes of hypoglycemia start with headaches. Often, the first sign of a mild attack triggers intense hunger. A child may complain of hunger pains or tell you that their stomach feels empty. If the child is well fed, complaining of intense hunger after a meal is a potential sign of a mild attack.

On the other hand, if the child is actively engaged in physical activity, complaining of the empty stomach should not cause panic. Under these conditions, it is better to let children relax and give treatment according to the situation.

Hypoglycemia can cause nausea and vomiting, especially in young children. Sometimes, vomiting and nausea can occur without any sign of a headache or hunger pains. Experts also suggest that vomiting is a natural reaction of the body to drain itself of the toxic substance.

Perhaps, the best thing to do is to watch for any signs of nausea. If the child vomits without prior signs of nausea, do not panic because any abrupt reaction to vomiting can make things worse. Just remain calm and try to diffuse the situation as calmly as possible.

The body often responds to hypoglycemia by releasing adrenaline, which causes sweating and pallor. Often parents report that the child’s skin tone turns grayish when their blood sugar is low. If you notice signs of sweat or pallor, immediately react to these signs based on the course of action recommended by the doctor.

Remember, sweating is a normal process during physical activity. As such, parents should not overreact to sweating during the passage of play and energy-consuming activity.

Dizziness and vertigo are also common symptoms of hypoglycemia. In young children, you may notice that they frequently fall when trying to stand up. If you notice unusual behavior when the child tries to walk, make the child sit or lay down to avoid possible injuries. Let the child relax and administer the dosage as appropriate.

Without any prior sign of headache and weakness, blurred vision is often a major sign of hypoglycemia. Older children are always more prone to blurred visions compared to young children.

Whenever older children complain of blurred or double vision, tell them to sit down or lie on a flat surface. Whenever problems with vision occur, let children know that they should let others know about their condition to ensure that someone is always nearby to help.

A child with low blood sugar often breathes more quickly than normal. They can also complain of a tingling or stinging sensation around the mouth.

Without enough glucose to sustain brain and muscle activity, an episode of hypoglycemia can cause loss of muscle strength and coordination. The child can drop things or stumble when walking. Their speech can be disjointed. In a baby, you may notice a lack of motion and slow physical movement.

irribility, mood swings, hypoglycemia in children
Lack of normal behavior is the first sign of hypoglycemia in young children. In diabetic children, doctors often recommend looking for abnormal signs throughout the day. If children react differently to a normal situation, let them relax before investigating for signs.

Irritability and sudden mood swings are common symptoms of hypoglycemia. Children may seem anxious or nervous during such episodes. They may have a burst of anger or cry with no apparent cause. Erratic, inappropriate behavior, lack of cooperation, and combativeness are possible clues of low blood sugar.

Brain activity decreases when blood glucose is insufficient to feed brain cells. As a result, an episode of hypoglycemia often causes confusion and inattentiveness. Teachers should be aware of these and other symptoms of hypoglycemia in case the child experiences an episode in school.

If your child is diabetic, let teachers, friends, and others know because they can help treat signs of diabetes and hypoglycemia by getting help. Sometimes children and parents are reluctant to share their feelings with others, which is a recipe for failure. Boost your child’s confidence by telling them that it is a normal disease that they can overcome with awareness, knowledge, and confidence.

A severely low blood glucose level causes drowsiness and lowering of the energy level. Signs of lack of energy are evident if you feel that your child is yawning very frequently. In certain circumstances, children also tend to look straight focusing on a particular spot.

Low energy levels are also imminent if children have difficulty waking up in the morning. If your child seems too pushy wanting to go back to sleep, this may also be a hint of hypoglycemia in a child with diabetes. It is also common for some children to sweat profusely at night or wet their bedding.

If levels fall below 40 mg/ dL, children can experience seizures. If nothing is done to rectify the situation, a child can quickly go into a coma. As a responsible parent, you should try not to panic because it will create immense psychological pressure on your child, who would be struggling to get out of the trauma.

Consult your child’s doctor about emergency plans for when the child has a seizure. You should always have a plan to deal with the most awkward situations. In fact, make a backup plan if you’re unable to get assistance, quickly. Knowledge and awareness are always a parent’s first line of defense against such attacks.

If your child is treated with hypoglycemia, you can use the following steps to deal with the problem. Before making plans for the treatment, always consult your doctor regarding the diet and the procedure.

As a first step, you can give 10 to 15 grams of simple carbohydrates orally to boost the sugar intake. For instance, you can use these diets:

• Glucose (2 Glucosport pills),
• Sugar (2 lumps),
• Fruit Juice or non-light Soft Drinks (100 cc),
• A glass of skimmed milk (200 cc)

After giving an energy boost, wait about 10-15 minutes to test the sugar level. If it has not reached the normal level, it is necessary to repeat the same carbohydrates diet. Don’t try to give more sugar than the recommended dose because an overdose can create a chemical imbalance in the body, which can be harmful to the recovering patient.

If glucose levels have not reached the normal level, give another 10 gram of carbohydrates. Try a long-lasting diet such as:

• 20 gram of bread
• 3 Mary cookies
• A glass of whole milk
• 2 natural yogurts
• A piece of fruit

If hypoglycemia levels are reached near a meal, the body will react quickly to absorb carbohydrates. As a result, you may see a quick recovery. On the other hand, if the child had just taken a meal, the rate of absorption may be slow; therefore, you need to be vigilant throughout the episode.

Under normal conditions, if the blood glucose reaches less than 70 mg / dL, you should give 5 grams of slow-absorbing carbohydrates to fulfill the appetite.

It should be mentioned that these quantities are examples of treatment options; however, the exact diet should be administered after consultation with an expert. Readers should treat these guidelines to gain knowledge and generate awareness of possible treatment options for hypoglycemia.

If the child recovers after being unconscious due to an episode of hypoglycemia or if the child experience seizures, don’t give an oral dose. Instead, such situations are best handled by administering a hormone known as glucagon, which is injected into the bloodstream using a small painless syringe.

The amount of dosage depends on the age of a child. For a child under 2 years, ¼ ampoules are sufficient. For children between 2 and 6 years, ½ ampoules are recommended, and for children above 6 years, a full dose of 1 ampoule should be administered.

The dose can be easily administered at school. Parents should let school authorities know about the health condition. Any health official at school can control the situation by providing the required quantity. Parents should also provide a bottle of glucagon to school authorities, and keep a note of the expiration date.

Many schools also train teachers to administer such doses. If the school offers such teacher training, parents should exempt teachers from any kind of liability in writing because it will make a trained teacher react to the situation quickly without calling health officials to help. After the child has recovered from the seizure or an attack, it is better to take the child to a nearby health facility.

In 90% of cases, hypoglycemia or cases of low blood sugar is related to diabetes. In these cases, the lowering of sugar is usually caused by some mismatch between the dose of insulin supplied and food intake, or by any medication that interferes with the effects of insulin. Low sugar levels can also be caused by excessive exercise in diabetic children.

Children with diabetes suffer from hypoglycemia because it often gets difficult to control insulin and glucose balance in the body. As a result, diabetic patients are prone to the disease due to the potential mismatch of food, medicine, or exercise.

In 10% of cases of hypoglycemia, diabetes is not the reason behind hypoglycemia. In these rare cases, hormone deficiency can be the leading cause of the endocrine-metabolic problem. The deficiency of hormone leads to an autoimmune disease or a disease related to the heart, kidneys or liver, which causes hypoglycemia in non-diabetic children. Often times, hypoglycemia in non-diabetic children can also be traced to the intake of a certain medicine used by the child.

It can also be related to some type of tumor. The organ most responsible for hypoglycemia in non-diabetic children is Pancreas. Pancreas balances the production of insulin in our body; therefore, hypoglycemia can be caused by a malfunctioning pancreas. Under these conditions, doctors try to identify a particular disease instead of focusing on diabetic solutions. Once the disease is rectified, symptoms of hypoglycemia tend to fade quickly.

In non-diabetic patients, hypoglycemia is usually caused by an enzyme deficiency, injury, or pre-diabetes. As such, there are two types of non-diabetic hypoglycemia:

The condition is mostly caused by a pre-diabetic condition where the body has difficulty in making insulin to control glucose levels.

Another major cause of reactive hypoglycemia is a problem with Pancreases. As the food passes quickly through the body to the small intestine, it causes diabetes. Often, stomach surgeries can cause such problems. Another rare kind of diabetes is the inability of an enzyme in the body to break down the food. This also causes the pancreas to malfunction.

Excess use of medicines such as aspirin, antibiotics, and pentamidine can cause hypoglycemia in non-diabetic patients.

Experts have also seen cases of a severe injury to a liver, heart, or kidney to induce signs of hypoglycemia in healthy children. In certain situations, the disease is genetically induced due to low levels of hormones such as cortisol, glucagon, epinephrine, and growth hormone. A tumor in the pancreas is also a type of fasting hypoglycemia.

An episode of hypoglycemia in non-diabetic children can often end within minutes. The child just needs to take some kind of sweetener that may include drinking orange juice, taking a sugar pill or eating candy.

On the other hand, hypoglycemia caused by long-lasting insulin in diabetic children can often take up to two days to last; however, almost all non-diabetic children are out of the danger zone if treated appropriately.

People with diabetes are prone to hypoglycemia throughout their lifetime. The patient needs to be vigilant to survive the attack. Often, patients are vulnerable at night because they cannot monitor their glucose levels. Similarly, there are no symptoms to alert them of the impending situation.

Repeated episodes of hypoglycemia can lead to impaired brain functions. To prevent the condition, experts recommend trying to reduce episodes where the levels may lead to an attack or coma.

Hypoglycemia is most commonly associated with diabetes. A simple answer to the question is, “Yes, it is treatable if diabetic children can overcome the underlying condition causing hypoglycemia”. Depending on the condition and severity of hypoglycemia, good eating habits, exercise, and regular monitoring of glucose levels can prove a long-lasting remedy to prevent damages and disease associated with hypoglycemia.

In non-diabetic children, hypoglycemia is mostly caused by a malfunctioning organ or a similar disease. Once doctors are able to rectify the problem, non-diabetic children recover quickly from hypoglycemia. Doctors also use surgery to treat tumors or replace missing hormones with medicine to cure the disease.

Mild symptoms of hypoglycemia can also be treated by eating candy or sweets. In case of a disease, hypoglycemia is cured by treating the diseases or undergoing surgery. In fact, the best solution is to adopt a healthy lifestyle, which will keep disease at bay.

For a diabetic child, the best option to treat hypoglycemia is to focus on treating diabetes. As of now, there is no cure for diabetes; therefore patients can only manage to force diabetes into remission because it will help keep episodes of hypoglycemia away from their daily lives.

Overall, parents should understand that hypoglycemia can be controlled by generating awareness among children. Parents should share information with their child, and train them to recognize signs of impending hypoglycemia. They should also talk to their children on how to react to an emergency.