Cyprus alternative to Glucogen/Hypo treatment for 2yr old

[Kirsty87]

Hi,

My 2yr old daughter has just been discharged from a Cypriot hospital and diagnosed with T1D.
We haven't been given anything to treat hypo other than the Glucopen and the more I read I should have something like Glucogen.

I'm particularly concerned about her hypo happening at night, any advice appreciated. We move back to the UK in 2 weeks but I'm anxious as she has dropped in last two days about what I would give a sleepy baby at night who won't eat.

Thanks

 

[Antje77]

Hi @Kirsty87 , welcome to the forum.

I'm sorry to hear your 2 year old has just been diagnosed, that's a lot going on suddenly.

We haven't been given anything to treat hypo other than the Glucopen and the more I read I should have something like Glucogen.

With Glucopen, do you mean an insulin pen or something to treat hypos?

but I'm anxious as she has dropped in last two days about what I would give a sleepy baby at night who won't eat.

If she has been going low in the past two days, have her insulin doses been adjusted to that? Are you receiving any guidance on doses at th moment? This soon after diagnosis, needed doses can change quickly, and it'll take time to find the right doses in the best of circumstances.

With nighttime lows, I'd urgently seek advice on dosing, you'd rather run a tad high at this stage than seeing lows.

Would she be willing to sip on some orange juice or coke while half asleep?

the more I read I should have something like Glucogen.

Have you asked the hospital if this is available for you?
Glucagon is usually only used with hypos where the patient is unconscious, which thankfully is a rare event. If it's used, you'll still need ambulance or hospital care afterwards as far as I understand (never needed it myself, thankfully), so it's not something to use just because your toddler is being stubborn about eating.

If ambulance/hospital care is quick where you are, calling them will be fine in case of emergency. If you're at a remote spot, I second trying to get emergency medication if possible.

 

[Kirsty87]

Hi @Kirsty87 , welcome to the forum.

I'm sorry to hear your 2 year old has just been diagnosed, that's a lot going on suddenly.

With Glucopen, do you mean an insulin pen or something to treat hypos?

If she has been going low in the past two days, have her insulin doses been adjusted to that? Are you receiving any guidance on doses at th moment? This soon after diagnosis, needed doses can change quickly, and it'll take time to find the right doses in the best of circumstances.

With nighttime lows, I'd urgently seek advice on dosing, you'd rather run a tad high at this stage than seeing lows.

Would she be willing to sip on some orange juice or coke while half asleep?

Have you asked the hospital if this is available for you?
Glucagon is usually only used with hypos where the patient is unconscious, which thankfully is a rare event. If it's used, you'll still need ambulance or hospital care afterwards as far as I understand (never needed it myself, thankfully), so it's not something to use just because your toddler is being stubborn about eating.

If ambulance/hospital care is quick where you are, calling them will be fine in case of emergency. If you're at a remote spot, I second trying to get emergency medication if possible.

Sorry reading this again this morning I’ve not been very clear. We have been given an orange hypo kit Glucagen for emergencies but we were told to use it when BS is below 70.

Having read a bit more this doesn’t appear to be the case? Please correct me if I’m wrong, I’ve had very little sleep since she was rushed to hospital and now we’re home I’m feeling the weight of the world on my shoulders. The language barrier has been quite difficult and pharmacies are even harder to talk to when asking for basics, we can’t even get hold of a sharps box.

My question was me looking for an alternative to glucogel, I’m hopeful she would sip on a juice but honestly I don’t know when shes so tired I would like something I could pop in her mouth that she won’t need to chew as a backup.

My little girl dropped to 64 yesterday afternoon and my anxiety is just building around it dropping, she sat around 100-110 through the night. Is that too low?

 

[Marikev]

Hei Kirsty, this must all be very scary for you. I’m a British granny living in Norway, diagnosed T1 2 years ago and I can empathize with some of what you are going through, language barrier etc. I don't know of any parents of young children on here who can offer better advise, hoping there are some…
I am prescribed a product called Baqsimi, which is glucagon, and is inserted up my nose, should I ever pass out from a hypo. But seeing as I am the one looking after me it would be down to whoever was around at the time to know about it and find it and use it! Mine is a one time use product, so no way to open it up to see how it works. When the old one expired I did open it up to see how it works.
You are using different units for measuring blood glucose to what I work with. Need to multiply the units I am used to by 18 to get to yours. Pretty sure the UK uses mmol/L, so my target range is 4-10.
So your little girl’s figure of 100/110 during the night would be just fine. I don’t know enough about the management of T1 in little children , the hospital staff should have given you some basic information.
I buy pouches of baby food, fruit yoghurt mixtures that I use for hypos, ie going below 4. Some need to be refrigerated, but here we can buy ones that seem to be OK kept at room temperature. I tried the savoury ones and found them to be disgusting, so stick with the fruity ones.
Things will settle down, but there is a lot to learn and take in.
best wishes from stormy Norway.

 

[Antje77]

Sorry reading this again this morning I’ve not been very clear. We have been given an orange hypo kit Glucagen for emergencies but we were told to use it when BS is below 70.

Having read a bit more this doesn’t appear to be the case? Please correct me if I’m wrong

If BG is below 70 you'll need to treat the hypo, but definitely NOT with the glucagon kit! I'm very happy you have the kit in case of emergency, but I wouldn't expect to need it.

A hypo can be treated with anything sugary, like the glucogel. But also with things like juice, sweets, sultanas, coke, full sugar ice tea, dextro tabs, cake icing, honey, etc.
With your worries about what she'll have, what about going to the store and simply buy lots of different things, especially things she likes so you can try if needed?
That said, most children will sip a juicebox if they're half asleep and someone puts the straw/sippy cup in their mouth with the instruction to drink.
I like using a spoonful of honey if I'm hypo but not wanting to eat.

we can’t even get hold of a sharps box.

Don't worry, just use an empty water bottle for now.

My little girl dropped to 64 yesterday afternoon and my anxiety is just building around it dropping, she sat around 100-110 through the night. Is that too low?

Being around 100 through the night is pretty much perfect in my book.
But I'm an experienced diabetic and I more or less know what to expect my BG to do, and you're new.
When I first started insulin, the diabetes nurse advised me to try to be above 140 before bed by eating some bread or crisps if I was lower than that. (A sandwich, crisps etc lasts longer in the system than sugary things, the goal was to nudge my BG up a little for a longer time, not create the short sharp spike you want when treating a hypo.)

We move back to the UK in 2 weeks

Do you have a GP in the UK? Can you contact them from where you are now?
Once you're in the UK, you'll need a referral to an endo to set up her diabetes management.

Like @Marikev said, the UK uses mmol/l, you're using mg/dl at the moment.
Here's a conversion chart, try to get used to the UK numbers, that's what you'll be working with when you're back in the UK.

 

[Hopeful34]

Hello @Kirsty87 and welcome to the forum.

I'm so sorry your daughter has been diagnosed with diabetes. That will have been so difficult for you to hear, and a massive learning curve.

I was diagnosed at the same age, many decades ago. Thankfully treatment has vastly improved since then, and as has already been said your daughter will be under the care of a hospital team, once you're back in the uk. They will be able to help you with all aspects of caring for your daughter, and also give you support.

My mum and dad used honey to treat low blood sugar, because it can be massaged into the gums of an unresponsive child. I also loved it as a toddler.

Take care, and ask any questions you have (there will be many). We're a friendly bunch, and there's a wealth of knowledge on this forum from people living with diabetes.

 

[Kirsty87]

Hei Kirsty, this must all be very scary for you. I’m a British granny living in Norway, diagnosed T1 2 years ago and I can empathize with some of what you are going through, language barrier etc. I don't know of any parents of young children on here who can offer better advise, hoping there are some…
I am prescribed a product called Baqsimi, which is glucagon, and is inserted up my nose, should I ever pass out from a hypo. But seeing as I am the one looking after me it would be down to whoever was around at the time to know about it and find it and use it! Mine is a one time use product, so no way to open it up to see how it works. When the old one expired I did open it up to see how it works.

Hi Marikev, I do hope you're getting on ok on your own, it's a lot to take in but I can imagine Norway is beautiful place to live too and hopefully a little more advanced than here in Cyprus to look after you.

You are using different units for measuring blood glucose to what I work with. Need to multiply the units I am used to by 18 to get to yours. Pretty sure the UK uses mmol/L, so my target range is 4-10.
So your little girl’s figure of 100/110 during the night would be just fine. I don’t know enough about the management of T1 in little children , the hospital staff should have given you some basic information.
I buy pouches of baby food, fruit yoghurt mixtures that I use for hypos, ie going below 4. Some need to be refrigerated, but here we can buy ones that seem to be OK kept at room temperature. I tried the savoury ones and found them to be disgusting, so stick with the fruity ones.
Things will settle down, but there is a lot to learn and take in.
best wishes from stormy Norway.

Thank you for the tips on the baby food and yoghurt pouches she will definitely enjoy those but I expect she'll have the same reaction to the savoury ones too. It's a lot to learn in a short space of time but I'm told and I've read so much on here already about everyone who battles this daily and it is normal! My little girl is taking it all in her stride luckily. Take care xx

 

[Kirsty87]

If BG is below 70 you'll need to treat the hypo, but definitely NOT with the glucagon kit! I'm very happy you have the kit in case of emergency, but I wouldn't expect to need it.

Thank you, I did think this was the case but there was still some blurred lines.

A hypo can be treated with anything sugary, like the glucogel. But also with things like juice, sweets, sultanas, coke, full sugar ice tea, dextro tabs, cake icing, honey, etc.
With your worries about what she'll have, what about going to the store and simply buy lots of different things, especially things she likes so you can try if needed?
That said, most children will sip a juicebox if they're half asleep and someone puts the straw/sippy cup in their mouth with the instruction to drink.
I like using a spoonful of honey if I'm hypo but not wanting to eat.

I will definitely try buying a few different things to try her with, this is a good idea and I can see how we can mix it up if we need to.

Don't worry, just use an empty water bottle for now.

Being around 100 through the night is pretty much perfect in my book.

This is a relief! I'm glad she's sitting where she needs to be and hopefully I can relax about it a bit now too.

Do you have a GP in the UK? Can you contact them from where you are now?
Once you're in the UK, you'll need a referral to an endo to set up her diabetes management.

Our current GP done a referral on Thursday so hoping we can get her an appointment pretty quickly when we get back. Thank you for the chart too, I'll have to study this a bit to get my head around the different numbers.

Thank you so much for you help! xx

 

[Kirsty87]

Hello @Kirsty87 and welcome to the forum.

I'm so sorry your daughter has been diagnosed with diabetes. That will have been so difficult for you to hear, and a massive learning curve.

I was diagnosed at the same age, many decades ago. Thankfully treatment has vastly improved since then, and as has already been said your daughter will be under the care of a hospital team, once you're back in the uk. They will be able to help you with all aspects of caring for your daughter, and also give you support.

My mum and dad used honey to treat low blood sugar, because it can be massaged into the gums of an unresponsive child. I also loved it as a toddler.

Take care, and ask any questions you have (there will be many). We're a friendly bunch, and there's a wealth of knowledge on this forum from people living with diabetes.

Thank you, I think I'll be here a lot asking questions and researching. I hope your T1D journey has gone well so far, I know it's a bumpy ride were about to get on but hearing from people like yourself is really reassuring that her life doesn't have to be different going forward.