Understanding Hypoglycemia and Hyperglycemia

Written By Julie .

When your child or teen is first diagnosed with Type 1 Diabetes, one of the biggest adjustments is learning how to manage blood glucose (BG) levels. It can feel overwhelming at first, but with time, you and your child will both become more confident in recognising symptoms and knowing how to respond. Two important terms you will hear again and again are hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar).

Here we’ll walk you through the basics, but remember: always follow the guidance given to you by your diabetes clinic team, as each child’s care plan may be a little different.

What is Hypoglycemia?

Hypoglycemia (often called a “hypo”) means blood glucose levels have dropped too low- usually below 4.0 mmol/L. Your clinic will help your child learn to recognise how they personally feel during a hypo, since symptoms can be different for everyone.

Common symptoms of hypoglycemia:

  • Shaking hands or trembling

  • Sweating

  • Dizziness

  • Hunger

  • Blurry vision

  • Tiredness

  • Difficulty concentrating

  • Feeling anxious or irritable

Trusting How Your Child Feels

One of the most important parts of managing hypos is learning to trust how your child feels. Blood glucose numbers are a really helpful guide, but they don’t always tell the whole story. Some children can feel “hypo” symptoms even when their BG is a little higher than 4 mmol/L, while others may not notice them until levels are much lower.

Encourage your child to share what they’re feeling- whether it’s shakiness, sudden tiredness, or just a sense that “something isn’t right”. This helps them to build awareness and confidence in managing their diabetes If they say they feel low, it’s always best to check their BG and treat if needed rather than waiting.

How to treat a hypo

Hypos should be treated immediately with a fast-acting glucose source. Common options include:

  • Lucozade/ Gatorade or other glucose-containing drinks- about 150ml (check the carb count per serving as varieties can differ)

  • Fruit juice- about 100-150ml

  • Jelly Babies- usually 3-5, depending on the size and carb content

  • Glucose tabs- follow packet instructions

After treating, re-check blood glucose in 10-15 minutes.

  • If it’s still below 4.0 mmol/L, repeat the treatment.

  • Once BG is back in range, a small snack containing longer-acting carbs (like a slice of toast or a biscuit) may be needed, especially if it’s a while until the next meal.

Tip: Always follow your clinic’s specific advice on treating hypos, as doses and recommendations can vary.

Tips to Help Prevent Hypos

While hypos can’t always be avoided, these strategies may help reduce how often they happen:

  • Always carry hypo treatments- encourage your child to keep fast-acting glucose with them at all times.

  • Check BG before exercise- and have a snack if levels are on the lower side. Your clinic can advise how much extra fuel is needed.

  • Stick to meal and snack routines- regular eating patterns can help keep blood glucose steadier.

  • Review insulin doses- if hypos are happening often, especially at certain times of the day, speak to your diabetes team about adjusting insulin ratios or basal doses.

  • Extra check after activity- physical activity can lower BG for hours afterwards. Extra checks (or a bedtime snack) may help avoid night-time lows.

  • Use CGM alerts, if available- setting alerts for low glucose can help catch a hypo before it becomes more severe.

What is Hyperglycemia?

Hyperglycemia (often called a “hyper”) is when blood glucose levels are too high. Every hospital or clinic has slightly different thresholds and guidance for treatment, so check what levels your own clinic recommends for correction doses or other steps.

Common symptoms of hyperglycemia:

  • Feeling very thirsty

  • Needing to urinate more often

  • Trouble concentrating

  • Feeling sick or nauseous

  • Headaches

  • Irritability or frustration

  • Blurry vision

  • Feeling shaky or generally unwell

Trusting Your Child’s Awareness of Hypers

Just like with hypos, every child or teen will experience high blood glucose levels a little differently. Some may immediately notice thirst or irritability, while others may only realise something is wrong when they feel sick or have a headache.

It’s important to encourage your child to trust their own signals and let you know when they don’t feel right- even if the numbers don’t look too concerning at first. Hypers can creep up slowly, so your child’s awareness of subtle changes in how they feel can be a valuable early warning sign.

How to manage high blood glucose

The main way to bring down high BG levels is with insulin, given according to the correction guidance from your clinic. Hypers should be corrected as soon as possible, while keeping in mind any clinic specific rules about how often to correct.

Tips to Help Prevent Hyperglycemia

While hypers will still happen (and are part of living with Type 1 Diabetes), these steps can help reduce their frequency:

  • Monitor BG regularly- whether by finger pricks or a Continuous Glucose Monitor (CGM)

  • Check carb counting accuracy- ensure meals and snacks are dosed correctly

  • Review insulin ratios- speak with your diabetes team if you feel current ratios aren’t working

  • Encourage exercise- physical activity helps the body use insulin more effectively

  • Prioritise sleep and hydration- both play a role in keeping blood glucose more stable

Final Thoughts

Learning to manage highs and lows takes practice, and no parent or child gets it perfect all the time. With support from your clinic and consistent monitoring, you’ll soon recognise your child’s unique patterns and symptoms.

Julie .
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