Hypos one hour and a half after evening meal?

[J's mum]

Hello!

I am brand new here, so apologies if my question seems a silly one! My son (aged 10) was diagnosed type 1 just over 2 weeks ago and we're slowly getting to grips with things.

He has had lots of hypos (in the 3s range) especially during the night. For the last few nights he has been having hypos in the 2s range (yesterday 2.2) and he very nearly passed out about one hour and a half after his evening meal. He has been having plenty of carbs (not too many!) with his meals and they have been balanced with vegetables. We give him his short acting insulin just before his meal. I would have expected the insulin to balance the carbs in his meal, but maybe I've got things wrong!?

I was wondering if anybody else has experienced this dramatic drop after tea and, if so, how have you overcome it? Also, is it normal to experience so many hypos (however mild) when newly diagnosed? Is it just part of the learning curve?

Thank you, in advance for your help!!

J's Mum

 

[noblehead]

Looks like you need to reduce his insulin dose to avoid the post meal hypo, speak with his diabetes team in the morning and they will advise you on how to adjust the insulin, for tonight just give him a few more carbs.

edit, yes it is quite normal to experience a few hypo's when newly diagnosed, it takes time to get the insulin dosing right.

 

[Heathenlass]

I would advise you to contact the diabetes team ASAP . It's not unusual to experience a bit of a bumpy ride initially, but those hypos are too frequent and too low. I suspect that the insulin dosages will need adjusting, possibly both the basal and the bolus. As you are both very new to this, it's not something I would recommend trying yourself .

I see @noblehead has just posted saying more or less the same thing ,and I agree about upping the carbs in the meantime. Also, test a little more frequently than you have been advised to do.

Good luck!

Signy

 

[ElyDave]

You really need to get a start on counting his carbs and matching the insulin to the meal. I can appreciate how difficult that can be only two weeks into this, I'm only 18 months diagnosed myself, but long term that is the way forward.

Also, is he typically quite active after dinner? Higher activity will increase insulin sensitivity and can cause those hypos, so if he runs around after dinner, you need to adjust the dose,

So 1) count the carbs, dose appropriately 2) when you've got that bit right, dose reductions for activity.

A bit further down the line, coem back and ask about basal testing as well, as that's all-important.

But don't worry, sound like you're doing great so far.

 

[noblehead]

There is a carb counting guide specifically for children, it might be worth you having a look J's Mum:

https://www.idf.org/sites/default/files/attachments/HI62553-Carbohydrate-Counting-for-Children.pdf

 

[jack412]

this is for when this crisis is over and it's normal to be so stressed out, you can't sleep
ask the nurse about courses you and/or your son can go on
for a bit of reading to get an over view of things, that may add to what you have already been given

Till you get to do your course, there is an online course for background and an idea to it. Free to registerhttp://www.bdec-e-learning.com/

This set of workbooks are worth reading and practising working examples only of carbs and doses
Don't change dose without nurse approvalhttp://www.diabetesinscotland.org.uk/Publications/9224 Overview

Workbook 1http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf
Workbook 2http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf

Carb listhttp://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf

Diaryhttp://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf

Basal testinghttp://www.diabetes-support.org.uk/info/?page_id=120

Sick day ruleshttp://www.diabetes-healthnet.ac.uk...flet_-_Sick_Day_Rules_for_Type_1_-_Nov_13.pdf
Sick day rules flowcharthttp://www.leicestershirediabetes.org.uk/uploads//documents/Type1 Sick_day_rules_InsulinV3.pdf

 

[J's mum]

Wow!! Thank you all so much - I am overwhelmed by everyone's support!!

 

[jack412]

one thing to keep in mind, is that USA carbs are different to UK carbs, with USA you have to deduct the fibre from total carb, with UK, the fibre is already deducted in total carb and you don't need to deduct it
I bet this is as clear as mud