Hypoglycemia can occur any time your child has too much insulin or too little glucose in her blood. But there are certain times when hypoglycemia is more likely - and when watching for symptoms is especially important.

One of those times is during and after exercise. The longer and harder your child exercises, the more important it is to watch for symptoms of hypoglycemia. If she exercises for longer than an hour (like during sports practices or games), she should take a short break and eat a snack to keep her blood glucose up. Blood glucose checking in the hours after she exercises is essential. Blood glucose levels could be lower for up to 24 hours. If your child participates in a sport, her coach and teammates must know that she has diabetes and how to treat hypoglycemia.

Nighttime hypoglycemia is also a danger. It can be especially hard to catch, because your child may not wake up enough to feel the symptoms. Signs of nighttime hypoglycemia include: damp pajamas and sheets in the morning; nightmares or restless sleep; waking up with a headache or still feeling tired; an unusually high blood glucose reading in the morning. (The body can react to hypoglycemia by releasing hormones that raise blood sugar levels - a rebound effect.)

If you or your child suspects that she gets nighttime hypoglycemia, wake her at 2 or 3 a.m. for a few nights and check her blood glucose. If it’s too low, treat for hypoglycemia before she goes back to sleep. If your child has nighttime hypoglycemia often, tell the doctor. The doctor may want to adjust her insulin or eating schedule.