Glucagone

Hello @Natt - Personally in the 5 years since being diagnosed I have not had a hypo episode which has required a glucagon injection. I have coped very well with jelly babies to treat my hypos within this time and keep very good hypo awareness so can generally feel when I am going low and able to self administer my hypo treatment. As he is newly diagnosed then his hypo awareness should be very good so he should be able to feel when he's going low, which means testing and glucose treatment to manage his hypos. I cannot advise you personally on what you feel is best for your son, but if he does need a glucagon injection then someone would need to be trained to administer this, it is generally something we are recommended to keep in our fridge at home, however personally I don't have one as I don't feel it necessary due to my hypo awareness and ability to manage my hypos.

I assume you are talking about the "orange box".
This is a absolutely back up strategy for hypos to be used only when your son loses consciousness during a hypo and unable to take any sugar by mouth and you are not able to get an ambulance.
I believe this is incredibly rare. In nearly 15 years, I have only past out due to a hypo once (which was alcohol related so not likely to happen to your son on a summer camp ) and on that occasion, an ambulance was called so the orange box remained sealed.
Given an ambulance will come very quickly and the orange box needs someone willing and able to use the glucogone, my orange box has expired and I have never bothered getting it replaced.

That said, if you feel more comfortable with the belt, braces and buttons approach, the orange box can stay out of the fridge for a long time so could go with your son to school every day.

I have experienced many hypos, but feel unqualified to provide advice for a child.

Natt said:

Hi everyone
I have a question about glucagone.As we are still new to T1D (3.5 months), I was wondering what is the recommended practice when it comes to taking the glucagone kit with you? My son just started a day camp and he has a glucagone stored in the fridge in the camp premises but they don't take it with them when they go to excursions?I am not that worried at the moment as he is currerntly on almost no insulin due to the honeymoon, but still we want to establish a good practice...

Do you also think that he should always have it around him in school and everywhere else he might go or a bunch of sweets would be enough??
Thanks for your thoghts

P.S: Any experience with hard hypo and how it was treated during e.g. a day of outside activities that you can share I would very much appreciate.
Nat

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Although the glucagon kit is meant to be kept in the fridge, it's apparently alright un-refrigerated (<25degC) for 18 months. Given that, I guess it can be carried around at will.

It wouldn't do any harm to have one at school, one at home and then one to travel with your son (kept by an adult) when he goes to things like camp or will be away from home for a while.

To be honest, in 30 years I have never used one either, and haven't had one in my possession for well over 20yrs. I would say, that as long as he has good hypo awareness, set some simple rules for treating hypos with something like a fun-size can of coke, a carton of orange juice or 4 or 5 Jelly Babies. The thing I was never taught, which for me is fundamental, is to eat the treat, and then wait. I used to just keep eating sweets until I felt better, and had no idea I only needed 20g carbs to rectify an average hypo.
Obviously, if there is more insulin involved, he may well need more carbs, but it's a simple rule no-one ever told me!

1) glucagon doesn't have an e on the end.

2) glucagon is hypo treatment if you're unconscious and unable to eat or swallow, if you can swallow hypos should be treated by ingesting sugar. If you get to the stage that a hypo knocks you out, an ambulance should be called whether or not you have glucagon available.

3) glucagon can be kept out of the fridge. So, since having it put on my repeat, the orange box is now carted round in my hand bag everywhere I go. But that's mainly because a) I've had unconscious hypos requiring glucagon treatment outside of home before and b) I know that most of my colleagues and work meetings are probably going to involve a doctor who will be able to work out what to do with the hypostop kit. There's no point carting it round if there's not someone who knows what to do with it when the hypo person is out for the count.

Natt said:

Do you also think that he should always have it around him in school and everywhere else he might go or a bunch of sweets would be enough??
Thanks for your thoghts

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Rather than sweets have some fast-acting glucose around at school and when out and about, Glucojuice has 15g of fast-acting glucose and comes in a handy size bottle that fits in coat/jacket pockets, it's excellent stuff and works incredibly fast, individually bought they are quite expensive but can you bulk-buy on the likes of Amazon (with free P&P) that brings the cost down, last time I purchased Glucojuice it was around £14.50 for twelve bottles.

I've never had to use a Glucagon Kit so no experience to offer, but for peace of mind it's worth keeping one in your fridge in case of emergencies.

As long as the diabetes is sensibly under control then I would suspect glucose tablets will be fine. I've not had a hypo in 4 years but always have glucose tablets handy. Just watch the alcohol as the liver can't dump emergency glucose (glycogen) if it's busy removing alcohol.

Please if he is going up mountains or river canoeing etc put it in his rack sack, as it may take hours for help to arrive. With canoeing maybe even consider two encase a canoe is lost.

It is bad enough dealing with someone without diabetes when they are in shock after a unplanned swim with ice hanging of the backs of all the canoes...... (There's the reason I had a 1l flask of hot sugar solution with me when I did canoeing in winter only had to use it 1 or 2 times a year.)

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Children have a greater surface area relative to volume and they also keep going until they drop if they are having fun, even if the fun is in 0 degree water with the air being -5c. As children while active also generate more heat, they overheat if they have a double wetsuits on (just as much of a health risk as being too cold).

Add in a much increased level of adrenaline etc due to the activity, or unplanned spin trapped in a oversized washing machine – yet that what it feels like to be “swimming” in a stopper at the bottom of a drop for example waiting for someone to get you out.

As soon as the adrenaline start to drop it is common for hypothermia to set in – the body can’t release BG fast enough to warm someone up by shivering. Get a hot sweet drink into them, and ideally get them into dry cloths in a preheated car and one on even thinks anything unexpected happened.

Now think about how much can go wrong with the above if there is not a warmed car, or few miles to go before the exit from the river or someone has Type1 – however greatest risk is when everyone thinks the risk has ended.

I have had glucagon administered. Once I was at home and had gone on a long bike ride in the searing heat and come home and fallen asleep on the sofa. I was about 14 at the time. I don't remember having any hypo symptoms on that occasion - I thought I was just tired from cycling a long way - my mum was unable to rouse me and the doctor was called.

On the other occasion I was living and working abroad and hadn't told anyone I was diabetic (yes, ridiculous!), and they called an ambulance, and the paramedics gave me glucagon.

If your son is going to be very active I would suggest that the camp staff have access to glucagon and are made aware of how to use it. It comes with excellent instructions. In my experience both times I have become unconscious have been several hours after sustained periods of exercise, and I think I didn't realise I was dropping, just tired from the exercise.

Both of these occasions were decades ago, at a time when I was habitually testing only before breakfast and supper. These days I test all the time, especially when exercising, and am fortunate in that I have excellent hypo symptoms which mean I am at much much less risk of unconsciousness as I can and do treat hypos myself with glucose.

I hope your son enjoys day camp, @Natt . If it would set your mind at rest, then ask them to take the glucagon with them on excursions. If he's doing really really sustained and energetic activities then keep an extra eye on him when he gets home at the end of the day, as it is often many hours later that a sudden drop may happen. If he's testing regularly and he and the staff have access to glucose, I am pretty sure that the glucagon is not likely to be needed. But as I say, if it would set your mind at rest, do ask them to have it with them - the pack is neither big nor heavy.

A glucagon kit was something I had in the fridge for the first few years post diagnosis. It was never used. I was an adult though. For a dependent I would probably have one you keep with his backpack and supplies that you keep with him throughout the day (marked with date so you know when it needs to go in bin after 18 months) and a spare in fridge. Highly unlikely he will ever need them though but no harm in having that base covered. Those small 15g bottles for hypos someone described would be ideal to have as well.
Hope you are all adapting ok to his diagnosis.