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DIABETES IN CHILDREN AND YOUNG PEOPLE: QUESTIONS ABOUT HYPOS

How could you tell if a toddler is having an insulin reaction? Sometimes his bad temper when he is overtired or hungry or wakes up from a sleep looks very like a hypo to me.

It is often very difficult to distinguish between an ordinary 2-year-old tantrum or a normal expression of developing independence and an insulin hypo. You will learn with experience and observation but you should do a blood test if in doubt, but if this is inconvenient you can be guided a little by a number of factors. Firstly, what time of the day is it?

If it is just before a meal or at a time when your child’s particular insulin is having its maximum effect, then it is more likely to be a hypo. If your child is sweaty and pale then once again it is more likely to be an insulin reaction. On the other hand, if something has happened which might reasonably lead to a tantrum or expression of bad temper, then you might find it a better course to ignore it rather than to play into his own hands by making a fuss over him. Certainly there will be times when you are not sure, and on such occasions it is probably better to treat it as a hypo and see the effect of giving an exchange of sugar. If he starts to improve soon after giving sugar, then it was very possibly an insulin reaction. It may be wise not to use too attractive a form of sugar in these situations (for instance, a compressed glucose tablet might be better than a barley sugar or lemonade) for fear that your child might ‘put on a turn’ in order to be rewarded with sugar.

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