July 14, 2000
Question from New York, USA:
My son is 14 years old and has Type 1 diabetes. Since his diagnosis, we have been testing for low blood sugars at 2 A.M. He is on Humalog and NPH at dinnertime. We have asked our health team what to consider low enough to treat at this time and have gotten some very different numbers from different members of the team. Some say to treat any number below 150 and others say only to treat below 80. We have tried to split the difference and treat below 120. Are there any recommendations that are documented anywhere? I have been unable to find any guidelines for a 2 A.M. reading. Last night we did not treat a number of 147 at 2 A.M. and he woke up at 70. It was lucky that he had to be up 1 hour earlier than he usually does.
Low blood sugar is usually defined as less than 60 mg/dl (some may say less than 45-50). Although there may be various opinions on the subject of hypoglycemia, I’m not aware of any authorities that would recommend treating a blood sugar of 100-150 as a low blood sugar. I usually recommend treating a low blood sugar that is causing symptoms (i.e. shaking, sweating, etc.) or if less than 70. A blood sugar that is above 70 and is not causing symptoms rarely needs treatment.
Also, make sure the person giving you advice about treating blood sugars has good experience with type 1 diabetes in children.
Additional comments from Jeff Hitchcock, The Editor:
You may wish to consider having your son try the Continuous Glucose Monitoring System by MiniMed, which will provide a detailed report of blood sugars during the day and night for three days. You’ll get a better sense of your son’s blood sugars during the entire night.