My two year old daughter, diagnosed at the age of 14 months, went low during her nap today, and her sitter had trouble getting her to come to. She felt very cold, and her lips were blue. Why would she get cold and her lips turn blue? This is the first time this has happened.

It is most likely from the hypoglycemia but there are several possible causes. In fact, hypoglycemic symptoms in small children differ slightly from those experienced by adolescents and adults in that small children are slower in their awareness of the impending low blood sugar due to low-induced impairment of their mental flexibility and then the coldness and blue lips (adrenalin-induced vasoconstriction of peripheral small vessels) may come before hypoglycemic reaction. Ask your sitter to check her blood sugar levels occasionally in order to pinpoint a possible undetected hypoglycemia.

MS

[Editor’s comment: I would also make certain that your sitter is comfortable with the treatment and symptoms of hypoglycemia, including the use of a Glucagon Emergency Kit if need be.

SS]