Every morning Hypo

[redding43]

So, we are just over a month in with our daughter, nearly 3yrs old and every morning is a nightmare of blood tests, hypo treatment, blood test again, insulin, breakfast and then get ready for nursery. Always a challenge with any toddler never mind one that apparently has diabetes.

She normally records 3.5-3.9 blood sugar level every morning and occasionally if we are lucky a 4.1. If at the lower range then a couple of jelly babies or a small amount of lucozade doesn't seem to push it much after 15mins so we have to repeat again.

We can't reduce insulin any more, she is only on novorapid before meals and that is only 0.5 each time.

She is eating really well and also sleeps well, normally waking up after 10-11hrs so I guess she is naturally fasting.

We are not worried about her, her blood sugars are always in the 4-5.5 range in the day, unless she is ill. Just all seems very strange as we would have expected to be treating high blood sugar and not the other way around

 

[redding43]

The hospital and diabetic nurse. She was diagnosed Type 1 just over a month ago when a blood test that was done by chance when she was unwell for several days and not eating properly revealed very high blood sugars (16 I think) and ketones.

She is eating well in excess of her suggested minimum carbs (of either 20 or 30g a meal). Plus before bed she has half a glass of milk and a couple of biscuits.

She goes to bed at about 7.30-8pm having had a full dinner at about 5.30 and the milk/biscuits just before we take her up.

We are back in hospital for a follow up appointment in a weeks time. They revealed last week that they had not carried out one of the tests for diabetes and they need to do that so she will have another blood test then

 

[donnellysdogs]

Sgree with @willowbunny.. With eating longer acting carbs before bedtime.....

Do you check at 3am in morn? Or during the night?

Is daughter having long acting insulin at night or mirnings? May be worth checking with consultant whether a change of timing of the long acting insulin would be advisable.

Other than that to really stabilise it may be a consideration to have a pump when you can actualy deliver no insulin and jyst minutes doses when necessary.

 

[redding43]

She doesn't have long acting insulin. Only 0.5 before each meal of novorapid. They tried the long acting but that was dropping her sugars even further so we were advised to leave it for now. We are not checking her at 3am - they haven't said we should??

 

[redding43]

Thanks. Could you make some suggestions for a suitable meal. Just worried about her going to bed on a full stomach

 

[redding43]

Btw, the hospital are advising us against the pump due to the very low amount of insulin she is having and her being in the honeymoon period

 

[donnellysdogs]

Would you ever consider asking for a pump that allows for minute doses?

Sorry didn't realise there was no long acting.

To me, it is just important to occasionally do a test during the night to get a complete 24hr picture.

For example... You may be able to give a small amount of porridge (only an example!!!) at 8pm...without a bolus. But ideally checking at 10pm and again at 3am. Only to give a snapshot fuller picture to find out if something works or not....

 

[redding43]

From what we had learnt we thought a pump might be the right way forward but, putting aside the hospital advice not to yet, wanted her and us to get comfortable with using needles etc just in case we need to again.

We will do the night time testing as well, thanks for the advice.

I admit that I thought with such a low dosage of insulin the problems we would be facing were hyper rather than hypo. Seems strange to be thinking about keeping sugars up rather than down. But I guess that is not unusual being new to all of this.

 

[redding43]

Ok....so at 3am she was 4.5. She went to bed at 5.5. She woke up this morning at 3.9

She went to bed at 8pm and woke at 7am (I know....luxury)

 

[donnellysdogs]

So at least now you can identify to consultants at what time during night that levels are dropping. Was there any snack pre bed time?

 

[redding43]

No, not last night. She refused even after much persistence.

Wouldn't everybody's sugars drop a little in the night? Sorry...new to all this

 

[donnellysdogs]

No, not everbodys do drop. Many people get dawn phenomenan which causes levels to drop at about 3 ish but then raise. Thats why it is interesting to check what is happening so you can let consultants know.
Trouble is a longer acting carb before bed may still not be long wnough acting to stop the lowering of the blood levels. And it certainly shouldn't have to be necessary to do this with a child who really doesn't want to eat later.
It would be interesting if at any point there is a time when an evening snack would be taken to do another 3am test.

 

[redding43]

Thanks again. We go back to the hospital this week and will ask them. I need to give them a call as well as they need to complete the blood tests which they omitted to do last time so I need to check whether we need to not have her eat beforehand.

 

[redding43]

So....we went to the hospital today for the first checkup.

They carried out the HbA1c blood test and checked the results of her blood sugars over the last month and are now questioning whether she has Type 1 diabetes at all!

They took further tests and we have to wait another 2 weeks for the results but in the doctors words 'strongly suspect the test will come back normal'.

If this is the case the next is a genetic test for a couple of more rare illnesses that have the same symptoms as Type1 (eg MODY). If these are negative then I suspect they will put it down to a 'blip'

In the meantime we stop the insulin injections and monitor her blood sugars only. Only taking action if their is a sustained period of them being high.

Watch this space....

 

[azure]

Wow - let's hope that provides some answers for you.

Do keep us updated. I hope the stopping of the insulin means your daughter feels better and you worry less.