Help - worried about sudden low blood glucose

[lisba1]

Hello,

I'd really appreciate any advice anyone can give me - my 2 year old daughter was diagnosed 3 weeks ago with Type 1 after suffering ketoacidosis. Her blood sugar levels have slowly come down over this time from the high 20's (mmol/l) to just about normal all the time. Except that things have started to go very strange over the last three days and she now seems to swing from very low (around 4 or just under), we rescue her with some carbs/glucose/juice and she jumps back up to 10 or 12, then she's back down to 4 again within about 2 hours. She is also waking up low in the morning (this morning was 3.8 after going to bed at 8.5) after previously only dropping slightly overnight.

Our diabetic nurse has been on hols this week and our last call to the childrens' ward for dose advice wasn't overly helpful (doctor was not v confident in giving advice) so we've been slowly reducing her insulin doses ourselves to try and stop these lows. She's on novorapid before meals and an evening dose of levemir. Her appetite is pretty much consistent (she eats little but almost constantly!) with the days before where her levels were much more stable so we think it's not due to changes in eating patterns. We halved her normal novorapid before lunch today and she still went back down to 4.2 v quickly.

Does anybody have any idea what might be going on? Could this be the 'honeymoon' period that we keep hearing about? Does it come on so suddenly?

Getting a bit stressed out with all these sudden lows, just when we thought we had it sussed :crazy: - especially the overnight drops (think we're going to cut her levemir back another 0.5 unit tonight from the original 3 units, down to 2 as 2.5 seemed to be too much - is this right, am guessing that this might be causing morning lows?!).

Many thanks in advance,

Lis

 

[robert72]

Hi Lis

None of us here are doctors and can't give advice, but based on what you've said about dropping levels overnight I would also suspect the levemir. If you do decrease it by 0.5u, leave a few days before making further adjustments. Hope you can get in touch with your DSN soon to resolve the hypos.

Robert

 

[TT17]

You could ask about a pump which would allow you to give much finer and less insulin. I have heard that 1 unit of insulin can bring young children's blood sugar down by 14 mmol/l so hence to big swings in some cases

 

[Spearmint]

The cold weather could be contributing to the lower levels, i would reduce by 0.5 units, wait 3 days and see what effect it has.

 

[lisba1]

A late thank you to you all for your replies. We reduced her dose of levemir further and in the end the diabetes nurse cut it down by half again and that has made all the difference in the mornings!

It seems as though we're going through the honeymoon phase now - though we get random highs as well as random lows now too! It changes day by day at the moment and we've still got so much to learn re: how carbs affect her bg, how much a unit brings it down and how exercise affects everything! She's a whirlwind at the moment and went from 10 mmol/L at 11.15 this morning down to 2.4 an hour later. It's frightening!

A pump is on the cards for the New Year and at least that will give us more control over the highs. A new set of kitchen scales are this Christmas's most-wanted and hopefully will make all the difference too!

Season's Greetings to you all and thanks again.

 

[jayne15]

Hi Lisa B

Can feel your pain we are week 11 (not that Im counting !) with my 7 year old who has been honeymooning since day 10. We have completely stopped the actrapid for 5 weeks now having weened down at 1 unit every time she had a hypo the previous day. (this was advised by the DSN) we are now only on maintenance long acting 5 units at breakfast and 2 at tea which a drastic reduction from when we started off. My little girl only has a couple of Hypos a week which is usually pre lunch now and best of all she is stable over night, It will get easier she does have occasional highes but we can usually link that to something she has had earlier. The key to our stability is exercise we do sport at least once a day and this gives us some more freedom in her diet (as this is more upsetting for my daughter than the injections !) in a nut shell if she is above 10 she cant have a treat so she does some exercise (dancing,star jumps ect if at home) this does the trick at the moment. in the early days she had to snack every 2 hours just to maintain 4 this has reduced now since stopping weaning and stopping the actrapid.

have a great Christmas and take 1 day at a time, things will settle and life will get less stressful. I cant believe I am saying this just 11 weeks into diagnosis.

I hope you all sett