My 13 year old son was recently diagnosed with type 1 diabetes, and I have concerns about hypoglycemia. Are seizures, coma, and death always a risk? What would happen if he did not wake up from hypoglycemia during his sleep? I have been told most kids wake up, but what if he didn’t? This is what the doctors say. Other say he will just have a hard time waking up in the morning. What do you say? How does one ease the constant fear of emergency hypoglycemia?

If a child did not wake up during hypoglycemia, there remains the possibility of seizures or sudden death. Scary? Of course, but hypoglycemia resulting in death is fortunately extremely uncommon: a variety of “compensating” mechanisms typically kick in first, such as a convulsion or other things. Most individuals with nocturnal hypoglycemia do wake up or are found by a loved one to be lethargic, convulsing, etc. I again emphasize that these events are not common.

You do not erase the fear of hypoglycemia. You temper it! How? With knowledge and preparedness. Experience will guide you just how much “wiggle room” your child has for hypoglycemia during illnesses, after significant exercise, etc. The glucose reading should be greater than 100 mg/dl [5.6 mmol/L] and some say greater than 120 mg/dl [6.7 mmol/L] at bedtime. A small protein snack or use of a nighttime snack with cornstarch can be tried. Your son should always wear medical identification. You should have accessible Glucagon Emergency Kits. Have one at home, school, grandma’s and perhaps in the overnight bag for sleep-overs. Continue your dialogue with your son’s diabetes team.

DS