From the Guidelines
The immediate treatment for a 5-year-old child with hypoglycemia is to give fast-acting carbohydrates orally if the child is conscious and able to swallow safely, with a dose of 15-20 grams of glucose as the preferred treatment, as recommended by the American Diabetes Association 1.
Key Considerations
- Provide 5-10 grams of glucose or simple carbohydrates, which can be given as 4 ounces (120 ml) of fruit juice, 4 ounces of regular (non-diet) soda, 1 tablespoon of honey, or 3-4 glucose tablets (depending on size) 1.
- After giving the initial treatment, recheck blood glucose in 15 minutes, and if it remains below 70 mg/dL (3.9 mmol/L), repeat the treatment 1.
- Once blood glucose rises above 70 mg/dL, provide a small snack containing both carbohydrates and protein, such as crackers with cheese or a half sandwich, to maintain stable blood sugar levels 1.
Special Considerations
- If the child is unconscious, seizing, or unable to swallow safely, do not give oral treatments, and instead administer glucagon - for a 5-year-old weighing approximately 20 kg, use 0.5 mg of glucagon via injection or intranasal route if available, and seek emergency medical attention immediately 1.
- Glucagon should be prescribed for all individuals at increased risk of level 2 or 3 hypoglycemia, and caregivers or family members should be instructed in its administration 1.
Rationale
Hypoglycemia requires prompt treatment because the brain depends on glucose as its primary energy source, and prolonged low blood sugar can lead to seizures, loss of consciousness, and potentially permanent neurological damage, especially in young children whose brains are still developing 1.
From the FDA Drug Label
The recommended dosage is 0.5 mg (0.5 mL) injected subcutaneously or intramuscularly into the upper arm, thigh, or buttocks, or intravenously. If there has been no response after 15 minutes, an additional 0.5 mg dose (0.5 mL) of Glucagon for Injection may be administered using a new kit while waiting for emergency assistance.
The immediate treatment for a 5-year-old child with hypoglycemia (low blood sugar) is 0.5 mg (0.5 mL) of glucagon injected subcutaneously or intramuscularly into the upper arm, thigh, or buttocks, or intravenously 2.
- Key points:
- Administer glucagon as soon as possible when severe hypoglycemia is recognized.
- Call for emergency assistance immediately after administering the dose.
- When the patient has responded to the treatment and is able to swallow, give oral carbohydrates to restore the liver glycogen and prevent recurrence of hypoglycemia.
From the Research
Immediate Treatment for Hypoglycemia in a 5-Year-Old Child
The immediate treatment for a 5-year-old child with hypoglycemia (low blood sugar) depends on the severity of the condition.
- If the child is conscious and able to swallow, they should be given a fast-acting carbohydrate source, such as glucose tablets or juice, to quickly raise their blood sugar levels 3.
- However, if the child is disoriented or unconscious, treatment with injectable or ready-to-use intranasal glucagon is recommended, along with a call for emergency medical assistance 3.
- Intranasal glucagon has been shown to be effective in increasing blood glucose levels within 15-30 minutes and is preferred by caregivers due to its ease of use 3.
- It is essential to note that the treatment of hypoglycemia in children should be guided by a healthcare professional, and the child's blood sugar levels should be closely monitored to prevent further episodes of hypoglycemia.
Considerations for Treatment
- The American Diabetes Association recommends that children with diabetes should have a glucagon emergency kit available at all times, which includes a prescription for glucagon and instructions on how to administer it 3.
- In cases where the child is experiencing severe hypoglycemia, it is crucial to call for emergency medical assistance and administer glucagon as directed by a healthcare professional 3.
- The use of mini-dose glucagon has also been studied as a potential treatment for non-severe hypoglycemia in adults with type 1 diabetes, and may be considered as an alternative to traditional treatments 4.
Importance of Prompt Treatment
- Prompt treatment of hypoglycemia is critical to prevent serious complications, such as seizures, coma, and even death 5, 6.
- Relative hypoglycemia, which is a decrease in glucose levels below prehospital admission levels, has also been recognized as a significant risk factor for mortality and subsequent absolute hypoglycemia in critically ill diabetic patients 7.