I recently educated my child’s middle school teachers about diabetes, hypoglycemia, hyperglycemia, and his medical care plan. One week later, I trained these seven teachers on how to administer glucagon in case of an emergency. One teacher had a very important question that I was not able to answer: how long after a student becomes unconscious/unresponsive does any type of brain injury begin? Is it 5 minutes, 10 minutes? The glucagon is kept in the nurse’s office which is a 5 minute walk. Or, do brain insults occur as that child is falling into the low numbers before becoming unresponsive or seizing?

Nobody can provide an exact answer to this question. The duration of hypoglycemia is linked to oxygen deprivation in the brain so it would be very unlikely to occur during school since either teachers or classmates would recognize a problem, odd behavior, “acting drunk, ” etc. Giving glucagon within a few minutes of losing consciousness or a convulsion would provide a rather rapid correction of the hypoglycemia. Frequent monitoring is the main preventive factor so that changes in pattern can be recognized, insulin and/or food adjusted for activity change, etc. Also monitoring, of course, allows the identification of low blood glucose levels so that juice or glucose tablets can produce correction before brain hypoglycemia “kicks” in.

SB