General information
Only very severe hypoglycaemia causes the children (childhood emergency) to lose consciousness as described above. In most cases, a lowering of blood sugar levels is noticeable in dizziness, cold sweat, concentration problems, headaches, restlessness, trembling and disorientation. Important here is the quick blood glucose test, which can be made within a few seconds from a drop of blood on the finger.
If the sugar level in the blood is less than 2.5 mmol, one speaks of hypoglycaemia. The causes of hypoglycaemia in children, which is not caused by diabetes, can be very different. In many cases, other hormone disorders can cause hypoglycaemia.
These include, for example, a hypofunction of the adrenal cortex. Here, the hormones cortisol and adrenaline are produced, which help the child’s body to counteract hypoglycaemia. In the event of a defect, damage or congenital dysfunction, this effect does not occur.
Since the adrenal cortex does not work independently, but is under the influence of the pituitary gland, damage to the pituitary gland can also lead to hypoglycaemia. In some cases, small benign tumors of the pancreas, so-called insulinomas, are also responsible. They produce more insulin, release it and thereby lower the blood sugar level.
Another hormone called glucagon is produced in the liver or muscle and can also provide glucose. However, a congenital glucagon deficiency or one that occurs as part of another disease is rarely the sole cause of hypoglycemia. Other causes include severe liver dysfunction associated with changes in glucagon metabolism, diseases in which the storage of glucose is disturbed (glycogenoses), a disturbed food intake, extreme fasting or dieting, and the use of certain medications.
Children suffering from one form of diabetes are very often affected by hypoglycaemia. In children suffering from diabetes, the problem is actually a permanently elevated blood sugar level, as the insulin produced by the body either cannot work properly or is not produced in sufficient quantities. In children in whom type 2 diabetes is only just becoming apparent, insulin production is initially significantly increased at the beginning of the disease.
This is a countermeasure initiated by the child’s own body to compensate for the weakened effect of insulin. As a result, too much of the sugar is transported into the cells after food intake and the blood sugar level drops below the normal level. The most common cause of hypoglycaemia in known diabetes, however, is an incorrect dosage of the drug therapy.
Patients who inject insulin have to adjust the dose to the amount of carbohydrates ingested, as well as to physical activity. If the amount of carbohydrates in the diet is estimated too high and too much insulin is injected, hypoglycaemia can quickly occur. If there is a lot of sport or unusually high physical activity, the blood sugar level drops reactively and thus reduces the amount of insulin needed.
If the insulin is injected too early before eating, or if gastric emptying is delayed by a high protein or fat content, the blood sugar level also drops before new glucose can be absorbed. Frequently, trembling of various muscle parts of the child’s body is observed in combination with acute cravings, nausea, vomiting or even the sudden appearance of sweating. Since sugar is an important energy supplier for the body and also for the child’s brain, when the blood sugar level drops, the brain immediately demands the supply of glucose so that it can work properly.
In the case of acute hypoglycaemia, the child’s brain releases certain messenger substances which cause the symptoms already mentioned and thus represent a warning sign for the body. The tremor thus serves as a very important indication to the body that there is too little sugar available and that it must be released from the remaining reserves as quickly as possible or replenished in the form of carbohydrates. Hypoglycaemia in children can be life-threatening and should therefore be detected and treated quickly.Acute hypoglycaemia is a drop in the blood glucose level to below the norm. Hypoglycaemia requiring treatment is referred to as glucose levels below 45 mg/dl. This corresponds to less than 2.5 mmol/l.
