Those children with either type 1 or type 2 diabetes mellitus are highly susceptible to hypoglycemia, although the reason for their susceptibility differs. Type 1 diabetics must also be concerned with high levels of blood glucose (hyperglycemia), as their bodies produce little to no insulin, the hormone which lowers blood glucose. Type 1 diabetics have β-cell dysfunction. Beta-cells are those cells in the pancreas which produce and secrete insulin. These children require regular injections of exogenous insulin to maintain regular glucose levels; as such, they may experience what is referred to as relative hyperinsulinemia. If they receive a regular dosage, but do not eat or eat enough, or become overly active, they may develop hypoglycemia. Also patients with diabetes tend to have problems coping with hypoglycemia because they often do not have normal responses in glucagon, the hormone which raises blood sugar levels, opposite to the actions of insulin.
Children with type 2 diabetes generally display hyperinsulinism, though that would not cause hypoglycemia, as insulin does not function normally in their bodies. However, other oral medications, such as sulphonylureas (Sus) and meglitinides, both of which stimulate β-cell function, can lower glucose levels. Also missing meals can result in hypoglycemia. The symptoms of low blood sugar in children fall into two categories.
In either type of diabetes, the most common causes of hypoglycemia include:
- Insuffient food or carbohydrate intake
- Physical or emotional stress
- Prolonged strenuous activity or exercise
- Excessive amounts of diabetic medications
Although rare, congenital hyperinsulinism strikes newborns and very young children. A defective gene passed on by one or both of the parents causes the pancreas to secrete excessive amounts of insulin resulting in prolonged and chronic bouts of hypoglycemia.