Blood Glucose taking a long time to recover?

[Twiggles]

For about the third night this week we have struggled to bring our youngest's blood glucose back up from a hypo She is a T1 diabetic, diagnosed in April 2012. She has not had many hypos but they have been more common lately, she usually complains of sore stomach if low, and this has on occasion been accompanied by vomiting.

She compalined again this evening, just as we were about to get her ready for bed. 2.6. Checked meter batteries, retested... 2.4. Ok time for glucose. Wait ten minutes.. 3.3 ok so starting to go up give it another five minutes, retest 2.7. And so began a cycle that is still continuing as I write while my wife takes over.

We rang the hospital half an hour ago. Did you test her properly. Have you checked the meter. When was she diagnosed? Last year? You shouldn't be ringing us then, you should really know what you are doing by now. Try giving her a chocolate bar (while telling we had just tested again and had a reading of 2.8). Quite angry with hospital now.

Does anyone else struggle getting blood levels up from a hypo like this, or experienced a similar cycle with it appearing to rise then suddenly dropping again? Anyone any advice?

 

[SamJB]

Unfortunately, most meters are accurate to within 15% or so. Those numbers, therefore, are consistent with each other. When you're low (or your child is) it's easy to get anxious about small changes in BG. Most people look for functionality when getting a meter i.e. Connect to a computer, calculate insulin doses etc. I've got a MyLife Pura because it is supposedly the most accurate and the readings are very consistent.

With hypos, once you've recovered from them, you need to reflect on why it happened. So that you can avoid them next time. How long after eating and injecting did the hypo happen? Does it regularly happen at this time? Did you carb count correctly? Are you in a routine: consistent meal-time carb quantities, eating at the same time?

Also, what do you give for hypo treatment? If I'm in the 2s I'll have some lucozade, after 10 mins have some more. Chocolate is a terrible suggestion as it can take a long time for it to raise BGs.

 

[Twiggles]

It happened about an hour and a half after dinner, and its the third this week. We carb count all her food, using food packaging labels and/or carbs and cals book, with all food measured using electric scales to ensure it is as accurate as possible.

Hypo's have been treated with gluco-juice or glucose tablets (15g fast acting in the juice and 4g per tablet). Yeah we were told not to use chocolate when she was diagnosed. Give glucose, get the blood sugars up then give a slow acting carb if outside a mealtime.

2 and a half hours since this hypo started and we have just got them to 4.3. She's had 55g fast acting carbs.. we 're both shattered and stressed and the poor kids exhausted.

 

[SamJB]

Is it the third time after your evening meal? If so, looks like the evening meal insulin dose is too high. My insulin sensitivity changes throughout the day, so don't expect the insulin:carb ratio to be consistent throughout the day. Perhaps have the same amount of carbs for evening meal for a week or so until you've figured it out.

A hypo an hour and a half after injecting is a classic symptom of too much short acting insulin. It does sound like an awful lot of carbs that she's had to treat the hypo. Is she recently diagnosed? Could be that she's in something calked the honeymoon period where her pancreas will start producing insulin for a short time before finally giving up. As you'd expect, it does increase hypo frequency.

Sounds like you're doing all the right things to me in terms if carb counting and hypo treatment. Poor kid, I know what it's like and can imagine how she's feeling.