Bg drop from 23 to 2 in 45 mins

[debbietowns]

Hi all,

I'm really puzzled by my 12 year old. Diagnosed type 1 in Dec 09. His insulin has been reduced again and again until they said stop it all together, as it could be Honeymoon.

Tonight we ate out and he had a choc dessert and his bg went up to 23 so i gave him 3 units of Novorapid. 45 mins later his Bg was 2.2. He felt really ill, he paniked and ate 5 jelly babies, small can coke, and 6 marshmallows! it went back up to 6 then 13. He is now eating toast as he is convinced it will drop again overnight.

My question is, why does Bg drop so low? The Novorapid should drop bg by 2 or 3 points per unit, i think. This keeps happening. Its like his body completely over reacts to the insulin.

Does this make any sense to anyone? I was told Friday that his cpeptide was 596 and have yet to work out exactly what that means. Possibly its not type 1?????????????????

very confused!
Debbie

 

[timo2]

Hi Debbie,

Is it possible that your son had some chocolate sauce on his fingers when you took the reading of 23?. If his hands were clean, then the erratic readings are most likely down to him honeymooning.

Assuming that your son's C-peptide result was 0.596 (nanograms per milliliter), then he's at the lower end of the normal range.

His insulin has been reduced again and again until they said stop it all together, as it could be Honeymoon.

As I understand it, it's not usually considered a good idea to completely stop insulin treatment during the honeymoon period. This is apparently because of an increased risk of allergic reaction when insulin treatment is recontinued. It's certainly worth double-checking with your doctor about this.

All the best,
timo.

 

[hanadr]

Could the insulin have gone straight in to the bloodstream?

 

[timo2]

Always a possibility, Hana; although, accidentally injecting into muscle is more likely.

Both would produce a very rapid dip in blood sugars.

 

[debbietowns]

Always a possibility, Hana; although, accidentally injecting into muscle is more likely.

Both would produce a very rapid dip in blood sugars.

I don't know anything at all about this. Where should he be doing injections? How do i know if its into a muscle? He did it in the top of his arm just above his elbow. his needles are 5mm which the nurse said was the shortest.

Thanks for your help
Debbie

 

[debbietowns]

Could the insulin have gone straight in to the bloodstream?

Hi thanks for your reply, how can i ensure it doesn't go into his blood stream? He has been taught to do injections in top of arms or thighs.

Thanks for your help
Debbie

 

[catherinecherub]

Hi debbie,
This might help,

http://www.diabeteshealth.com/read/2009 ... practices/

Catherine.

 

[HELEN11]

Do you always inject in the upper arm I am told by the Diabetes nurse that I should not inject my wife in the arm- only in the abdomen or thighs.?

 

[debbietowns]

Do you always inject in the upper arm I am told by the Diabetes nurse that I should not inject my wife in the arm- only in the abdomen or thighs.?

He has been told to rotate the sites. So arms or legs or tummy. Last night he did it in his arm, but he keeps saying the needles are too long but nurse said 5mm is shortest you can have. What do babies use i wonder?

Thanks
Debbie

 

[hanadr]

The object isto get a "puddle" of insulin just under the skin in the fat layer, so that it's absorbed slowly over a while. This can be quite difficult in a person without much fat.

 

[debbietowns]

The object isto get a "puddle" of insulin just under the skin in the fat layer, so that it's absorbed slowly over a while. This can be quite difficult in a person without much fat.

Aaahhh, i see. He is quite skinny. He has just agreed to try injecting in his tummy, so we will see how that goes.

Thanks for your help, i get much more support help and ideas from here than from our nurse!

Debbie

 

[cugila]

If he hasn't got much fat, make sure you 'pinch an inch' between thumb and forefinger, to ensure the injection goes into the subcutaneous tissue (fat) and NOT into muscle.

 

[diabetesmum]

Hi,
Hi
I would also be cautious in assuming that 1 unit of Novorapid only drops his BG by 2 or 3 points.
They cannot know this about your son this early on, it's just an 'educated guesstimate' they have made based on his age, weight etc. But everyone is different, and things change all the time. As this has happened, my advice would be to 'up' his correction ratio to 1 unit to drop him 5 points or even 6 or 7. Then test, test, test, every 20 mins after giving a bolus and track the BG coming down. If he is dropping very fast you can then intervene and stop a bad hypo before it happens.

You can always increase the ratio again if need be, once you get a better feel for things.

After you have done this a few times, you will get a much better idea of his sensitivity to Novorapid, although as he is still honeymooning things will inevitably be somewhat erratic and unpredictable.

Hope this helps.
BW
Sue

 

[Fujifilm]

Aaahhh, i see. He is quite skinny. He has just agreed to try injecting in his tummy, so we will see how that goes.

Be aware injecting into the tummy can cause it to absorb very quick. If I want to lower BG quick I use my tummy.

Why it can suddenly drop is a mystery to me. I had a bad few days last week and its the worst feeling ever.

If I ever get a relly high reading I always re-test, but wash my hands before doing the second test just in case its a dodgy reading or contamination on my hands. Same when I get a really low reading, although the panic usually sets in and I empty the contents of the kitchen in my mouth first :lol:

 

[leggott]

Hi, I have to agree with Sue, both my kids are still in the honeymoon phase and 1 unit usually reduces their blood by 5 - 7 mmol. Like Sue says, it's better to go on the side of caution and give a smaller amount than you think you need, note the results and test every 1/2 hour or so and see what happens. At the start its a lot of trial an error, before you get the ratio and correction amounts right. Good luck.