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November 12, 2004

Hypoglycemia, School and Daycare

Question from Vancouver, British Columbia, Canada:

My daughter is seven years old and was diagnosed about a year ago. Her A1c is usually between 7.5 and 7.9 %, which we are told is in target range. Her school is concerned that she goes low an unusual amount. She probably goes low an average of one or two times each day. This is due to a variety of different reasons, including unplanned exercise, stress, etc. When her insulin is reduced accordingly, even by one-half a unit, she is 13 to 18 mmol/L [234 to 324 mg/dl] for the entire day. It is my understanding that children with type 1 diabetes have more lows because of the unplanned games of tag that break out between kids, because of growing, because of emotions, etc. But, am I wrong? Is she having way more episodes of hypoglycemia than average or normal? She is very good at catching her episodes herself and is very in tune with her body. She rarely goes below 3.1 mmol/L [56 mg/dl] and the lowest she has ever been, and this was only once, was 1.8 mmol/L [32 mg/dl].

Answer:

My only concern is learning. Mild hypoglycemia can affect learning. Some lows, a few a week, are expected. A couple a day seems a bit too many. Look at the snacks and see if you can’t maybe add a few carbohydrates to avoid the lows.

LD