Technique Keeps Diabetic Children Out of ER

Teaching parents a fresh approach to an old medical problem is helping kids with diabetes stay out of the emergency room.

Developed by doctors at Baylor College of Medicine, the approach, called mini-dose glucagon rescue, puts control back into the hands of parents.

"Insulin and diet can keep the blood sugar levels of kids with insulin-dependent diabetes under control most of the time," said Dr. Morey Haymond, a Baylor professor of pediatrics and director of the diabetes clinic at Texas Children's Hospital.

"But, when a child can't eat due to a common illness like the stomach flu, or won't eat as a form of rebellion, problems with hypoglycemia, or low blood sugar, can develop. Unfortunately, at that point, parents' options have been fairly limited and unattractive," said Dr. Haymond, also a researcher at the USDA/ARS Children's Nutrition Research Center at Baylor.

According to Dr. Haymond, when an insulin-dependent diabetic child refuses food or can't eat, parents naturally worry about hypoglycemia. As a result, they often believe they must force food on a sick or reluctant child, make a trip to the doctor or emergency room for assistance, or give their child a shot of a potent hormone called glucagon, which has the opposite effect of insulin.

"Parents often think of glucagon as a last resort or emergency measure to prevent convulsions when blood sugar levels get dangerously low," he said. "The amount normally given must be administered with a `real' shot into muscle tissue, rather than under the skin, as is the case for insulin. It can also cause nausea. Because of this, many parents prefer a trip to the ER."

The mini-dose glucagon rescue technique sidesteps these problems by using a dilute solution of glucagon that can be administered just like insulin. Parents can also monitor the effect of the glucagon using the same sampling technique used to test for blood sugar when insulin is given.

"This type of shot is much more comfortable for parents and the child," Dr. Haymond said. "The dilute solution does not cause nausea, so parents might use it early in the course of a child's illness, saving them and their diabetic children undue conflict and trips to the ER."

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©2006 Texas Medical Center

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