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Diabetic Insulin Reaction (Infant or Toddler)

Children with type 1 diabetes often get insulin shots (injections). If the insulin level is more than the body needs, low blood sugar (hypoglycemia) results. This condition is sometimes called a diabetic insulin reaction or insulin shock. A diabetic insulin reaction can happen if too much insulin is given. It can also occur if the child is more active than normal, eats too little, or is ill.

An insulin reaction happens quickly. Symptoms can include:

  • Having nightmares or waking up crying out

  • Feeling hungry

  • Having a stomachache or upset stomach (nausea)

  • Being shaky, sweaty, or pale

  • Having a fast heart rate

  • Being fussy or crying for no reason

  • Feeling weak or tired

  • Feeling anxious or confused

  • Acting giddy or angry

  • Being clumsy

In severe cases, a child may have a seizure, faint (lose consciousness), or go into a coma.

Home care

  • To treat an insulin reaction, test your child’s blood sugar (if possible). Then give your child something to eat or drink that has 15 to 20 grams of fast-acting sugar. This is to raise the blood sugar level. Choose something you know is safe for your child to eat or drink. This could be:

    • Glucose gel (see package directions for serving size)

    • 5 to 6 ounces of regular soda such as cola

    • 4 ounces of fruit juice

    • 2 tablespoons of raisins

    • 1 tablespoon of honey (if your child is at least 1 year old)

    • 7 to 8 pieces of gummy candy or hard candy

  • If giving another source of fast-acting sugar, check the food label. Find the serving size needed to get at least 15 grams of sugar.

  • Wait 15 minutes; then test your child’s blood sugar again. The blood sugar level may still be lower than the range advised by your child’s healthcare provider. If this is the case, then give your child another 15 to 20 grams of fast-acting sugar. Repeat these steps until the child’s glucose level is 70 mg/dL or above. Call your child’s provider for advice, if needed. If blood sugar does not improve, call a healthcare provider right away.

  • Once your child’s blood sugar level returns to normal, they should eat a snack or meal. This will keep the blood sugar in a safe range. 

  • If your child has fainted, give a glucagon shot right away. An insulin reaction that is not treated can affect brain development. A blood sugar test is done 15 to 20 minutes after the shot.

Prevention

  • Check your child’s blood sugar level, as directed by the healthcare provider. Try to keep the blood sugar in a normal range. Check the blood sugar more often when your child is ill or very active.

  • Make sure that your child eats healthy meals and snacks on a regular basis. It's important not to skip meals. Your child should eat a snack before active play.

  • Keep a record of your child’s reactions. Include insulin given, activity level, and symptoms.

  • Tell caregivers about your child’s condition and how to treat any reactions.

  • Have your child wear a medical ID bracelet that identifies them as having diabetes.

  • Call your child’s provider if you have any questions about how to care for your child.

Follow-up

Follow up with your child’s healthcare provider, or as advised. Your child’s insulin dosage may need to be adjusted. Follow the provider’s instructions. They may also advise a different type of insulin or a glucagon injection kit. For example, some types of insulin can be given after a child has eaten (instead of before). This may help greatly in choosing the correct dose.

When to get medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Two or more reactions within a short time of each other

  • An insulin reaction with no apparent cause

Call 911

Call 911 right away if your child has severe reactions such as:

  • Seizures or convulsions

  • Fainting (losing consciousness)

  • Trouble breathing

Special note to parents

Insulin reactions may occur even when you do your best to prevent them. As advised by your child's healthcare provider, be prepared. Always carry with you a source of glucose that can be quickly and safely given, or a glucagon injection kit.

Online Medical Reviewer: Callie Tayrien RN MSN
Online Medical Reviewer: Liora C Adler MD
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Date Last Reviewed: 9/1/2022
© 2000-2024 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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