Low Blood Sugar Safety for Children with Type 2 Diabetes


According to the American Diabetes Association, there were approximately 5,800 new type 2 diabetes diagnoses in 2014 and 2015 in adolescents and children under 20. Newer data is somewhat limited, as this is an under-researched area. Doctors may treat children with type 2 diabetes with different medications and therapies depending on their unique needs. 

Although doctors may recommend lifestyle changes first for children with type 2 diabetes, they may add insulin therapy to their diabetes management regimen if they’re having trouble keeping blood sugar levels in their goal range.

Whenever your child uses insulin, they are more prone to experiencing low blood glucose levels, also called Hypoglycemia, also known as low blood sugar, is when your blood sugar level drops below 70 mg/dL (3.9 mmo/L). Having low blood sugar is dangerous and needs to be treated right away.hypoglycemia. If your child runs into a low blood sugar event, here are our top tips for feeling prepared to treat them successfully!

Understanding your child’s A1c

A1c is a blood test that helps determine if your child’s diabetes management plan is working well. A1c tests are recommended every three months in type 1 and type 2 diabetes patients. The results give you a general idea of what your child’s blood sugar levels have been during the previous three months. Every A1c reading translates to an average blood sugar level with this simple calculator.

Achieving your child’s goal A1c can be challenging, especially if your child is newly diagnosed. But it’s important to talk to your child’s healthcare team and learn about other tools to bring blood sugar levels down into a safe and healthy range.

Checking blood sugar levels every day with a blood glucose monitor is crucial for managing diabetes! The most recommended times of day to check blood sugar levels include: when you wake up, before eating a meal, two hours after eating and before bed. If your child is taking insulin, their healthcare team will likely also suggest daily blood sugar monitoring using a blood glucose meter (BGM) or a continuous glucose monitor (CGM). 

Using a BGM or CGM may feel overwhelming at first, so start small! Choose two or three times of day to start checking your child’s blood sugar, like when they wake up, before lunch and before bed, to get an idea of where their blood sugar levels are.

Learn (and share) low blood sugar warning signs

Since not everyone with type 2 diabetes treats their condition with insulin, low blood sugars can be more dangerous in patients with type 2 diabetes (T2D) because it is under-reported and under-identified. While people with type 1 diabetes (T1D) are taught early in their condition about low blood sugars, many people with T2D are not. 

Children with T2D may have an especially tough time acknowledging low blood sugar events. They might not even know what they’re feeling is low blood sugar until it becomes dangerous. 

Low blood sugar warning signs vary but typically fall within these categories:

  • anxious feeling
  • behavior change similar to being drunk
  • blurred vision
  • cold sweats
  • confusion
  • cool pale skin
  • difficulty in concentrating
  • drowsiness
  • excessive hunger
  • fast heartbeat
  • headache
  • nausea
  • nervousness
  • nightmares
  • restless sleep
  • shakiness
  • slurred speech
  • unusual tiredness or weakness

Some people might feel a combination of these symptoms or none at all. The longer your child has type 2 diabetes, chances are, the better you will be at reading their body language and identifying the warning signs of low blood sugar.

Start the conversation early. Ask your child how it feels when they go low so you can create the best support system for them and help equip them with the skills they need to treat low blood sugar symptoms independently if you’re not near them.

You may be able to prevent them from falling to 3.9 mmol/L70 mg/dL or lower by treating symptoms as they come. When their blood sugar is falling, they can start to treat it to prevent it from falling faster, even if it’s slightly above 70 mg/dL when they begin to feel it (typically between 70-5.6 mmol/L100 mg/dL). When your blood sugar is low, experts advise treating with 15g of fast-acting carbohydrates and then waiting 15 minutes to re-evaluate and treat again, if needed.

Keep low blood sugar snacks close

Everyday situations that may lead to low blood sugar include:

  • Taking too much mealtime insulin
  • Not eating enough for the insulin administered
  • Exercise or sporting activities
  • Hormone changes
  • Changes in weight, growth and age that lead to changes in insulin needs
  • Illness
  • And so on

Be prepared for low blood sugar events by storing fat-free fast-acting carbohydrates close. Juice, hard candies, glucose tablets and gummy candies all work well. Fat-free is ideal because fat slows the absorption of carbohydrates, while in the case of a low blood sugar, they need to be absorbed by the body quickly. You may consider keeping low blood sugar snacks in your purse or bag, your child’s backpack, your family car, your child’s classroom and other places your child frequently visits.

If your child isn’t ready to take on the responsibility of handling their low blood sugar snack supply themselves yet, that’s okay! Introduce self-management steps as they grow and become comfortable. If helpful, enlist the help of their coaches, teachers, babysitters, etc.

Connect with their teachers and coaches

Whenever your child starts a new school year, it’s a great idea to reach out to their teachers to ensure they have a clear understanding of your child’s condition and when to watch out for low blood sugar levels. Having more people in the know will only benefit your child if they go low.

Their teacher might even be willing to keep fast-acting carbohydrates in their desk for any potential low blood sugars during class.

Consider sending the school links to essential guides like:

You might get the whole class involved if your child is comfortable—the more awareness you can generate about low blood sugar warning signs, the better. Your child’s friends and classmates should feel empowered knowing they can help.

Communicate with their friends’ parents

If your child is going over to a friend’s house, it’s always in your child’s best interest to let their friend’s parents know about low blood sugar warning signs. Ensure that your child brings low blood sugar snacks with them whenever they go to a friend’s house, and let their parents know what they are for.

If your child doesn’t have a mobile device, you should leave your phone number with your child’s friend’s parents in case of emergency. The more you teach your child’s community about low blood sugars, the more support they’ll receive and the safer they will be. 

If your child takes insulin to manage their diabetes, understanding low blood sugars is a must! The more you learn as a family about type 2 diabetes, the more your child will feel empowered to manage their disease and live a full life.

Educational content related to type 2 diabetes is made possible with support from Lilly Diabetes. Beyond Type 2 maintains full editorial control of all content published on our platforms.

This content mentions Lilly, an active partner of Beyond Type 1.
News coverage by the Beyond Type 1 team is operated independently from any content partnerships. Beyond Type 1 maintains full editorial control of all content published on our platforms.

WRITTEN BY Julia Flaherty, POSTED 03/17/22, UPDATED 10/04/22

Julia Flaherty is a published children’s book author, writer and editor, award-winning digital marketer, content creator and type 1 diabetes advocate. Find Julia’s first book, “Rosie Becomes a Warrior.” Julia finds therapy in building connections within the diabetes community. Being able to contribute to its progress brings her joy. She loves connecting with the diabetes communities, being creative and storytelling. You will find Julia hiking, traveling, working on her next book, or diving into a new art project in her free time. Connect with Julia on LinkedIn or Twitter.