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Hello and could do with some advice please

R

Rach85

Member
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21
Hi all,

My 6 year old daughter was diagnosed late Feb with type 1. The diabetic team have said she is in the 'honeymoon' period and at the moment is constantly having hypos after breakfast and sometimes before bed. Her units are 1 per 30g for breakfast and 1 per 25g for evening meal with Novarapid. She is on 3 units of levemir for bed and the diabetic team have said that if she's less than a 7.0 before bed give her a snack. She then hits a 10 and is having a hypo some mornings at 5.30. I am wondering why i am giving her a snack before bed if she is not hungry. If i was to send her to bed on any number, the diabetic team say she would only drop 2mmls with the 3 units, so why is she dropping in excess of 6mmls and how would i get out of giving her the snack?

Sorry for the ramble but any advice would be amazing
 
It must be incredible worrying for you & scary for your daughter. I can't offer any advice but there is a whole section on the forums for young diabetics & for parents, so you may find some help there.
 
Hi Rach85.....It's sound advice to give carbs if below 7mmol/l before bed as nighttime hypos in the young can be serious. Insulin dose is personal. What works for me will not be appropriate for your daughter. Honeymoon is a blessing and a curse, it can be a bit erratic as you say. Hypos after breakfast is strange and suggesting pre meal Insulin is too high for her.....Mark
 
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Hi @Rach85 , welcome to the forum

I am by no means an expert, and I can't imagine what you must be going through, having been that bit older when I was diagnosed myself. However, to me, it sounds like her insulin doses could do with adjusting, given that the hypos have a 'pattern' to them.

I see @himtoo is online, and is very knowledgeable, so I will tag him for you. I can't think of anyone to wit, but there are definitely quite a few parents on here too with children of your daughter's age.

Good luck!
 
Hello, welcome to the forum. If you're asking about the food before bed then I might be able to offer some advice.

She will need to eat something with carbohydrate in it before bed to avoid a night time hypo.
If she isn't hungry and doesn't want to eat then try to find something with suitable carbs in it that is small, maybe a chocolate bar for example. This isn't ideas as you may want food that is medium GI before you go to bed so it'll last longer overnight.

Some potentially useful links:

https://www.diabetes.org.uk/Guide-t...es-and-diabetes/Glycaemic-index-and-diabetes/

http://www.diabetes.co.uk/forum/threads/bedtime-snacks.55852/

It may also be worth speaking to your diabetes team about the matter, they should be able to advise you on what to do.
 

Hi @Rach85

How long after breakfast does she have the hypo? How long after her evening meal does she have the hypo before bed?

Eating a bedtime snack is wise to avoid a nighttime hypo. The snack before bed is nothing to do with whether she's hungry or not. It's just to keep her blood sugar ok overnight.

How could you get out of giving her a snack? Well, you could look into insulin pumps. They allow you to fine tune basal making a snack less necessary, and reducing the risks of a hypo overnight.

How old is your daughter? There are other parents of Type 1s here and plenty of adult Type 1s wh can give you support

It's still very early days and it sounds like you've made a good start
 
Also, just wondering... have you got 1/2 unit dose pens?

Would consider asking consultant about an insulin pump, but your child may be better off with tresiba back ground (basal) insulin. Not sure if it can be given to younger children tho? I know of a 12 year old using it.
 
 

Hi,

Thank you all for your advice. My daughter is 6 and has been given the ratio of 1 to 30g units for breakfast, having a hypo 2/3 hours later. She is then given a snack after 75ml lucozade to treat the hypo. Spoke to he diabetic team and they have said to adjust to 1-32g which i don't believe is going to make a blind bit of difference, as that's pretty much what she's been having anyway. She physically can't eat what they are telling me to feed her. The last few mornings i had changed her to half of the dose (so 1 unit to 60g) to check out what happened while she was off school and still hypos. She was 5.6 before bed last night, so i gave her 2 slices of small wholemeal toast 16g carbs and she dropped to 5.8 before i went to bed at 11.30, so checked again at 5.30 and she was 3.3. don't know own why i am feeding her up to get her sky high but still giving her 3 units. This is the bit that does not make sense. Again hypo today 2/3 hours after breakfast on half a unit per 30g.

Thanks for all your advice
 
@Rach85 That sounds like it's possible the hypos are connected to her basal insulin dosage. Perhaps you could ask her team about that and discuss if a small reduction in the Levemir might be something to try.

If she's going low overnight then that's far more liley to be her basal. Also, as yours as you halved her breakfast bolus and she still hypoed then that sounds like it might be related to basal too.

Do you have a half unit pen for the Levemir?

Also, bear in mind that erratic sugars are very common during the honeymoon period and these can cause lows. If she always has a low after breakfast then you could pre-empt that with a snack. When I was in y honeymoon period, my own pancreas often used to make some insulin late morning and send me low, so I used to eat a biscuit or some fruit.
 
Hi Rach85,

I have a 6 year old girl T1 as well but diagnosed July 2016.
Its the Levemir that will need to be reduced here. Looks like she is having far too much. It should only go up/down by 1.7 mmol whilst fasting (i.e. overnight). This might also be contributing to the post breakfast drop.

It took us ages to get this right and only after getting the FreeStyle Libre could we see the full picture of what happened overnight. The bedtime snack is the hardest decision we make. But we have found it is far easier to inject her with a half unit at night rather than try to wake her and get her to eat something. Also, what works one week mot work the week after but that is the frustration of this thing.

Best of luck with it and fire away with any questions.
 

Hi,

Thank you again

We do have a half unit pen, and she has had her Levemir dropped from 5 the week after diagnosis on 16th Feb, to 4 and the past 2 weeks to 3 units.

It seems that since her diagnosis she has needed less and less insulin each week. I have asked the diabetic team if her Levemir can be adjusted. However the diabetic team are appearing to be reluctant to even take notice of this. This morning she was 6.6 before breakfast and had 1 unit novarapid for 32g carbs, when she was tested at school 2.5 hours later she was 2.9. But they are saying that they are only willing to change her 2g carbs per time, for breakfast and unwilling to change the levemir again. She has felt sick and dizzy all day at school due to another lower reading after lunch.

After she has breakfast at 7.45 she is then taken to school and the care plan that has been set up for her states that she wont be tested until first break at 10.30, so 45 mins later than I would at home. But the diabetic team have said that she needs testing at break so not to disrupt lessons, but I may ask the teacher tomorrow to check her at 9.45 to see if she is low then or if the 45 mins is having any impact. The school have been amazing so I'm sure they wont mind.

The diabetic nurse is calling me on Thursday to see how things are, so I will be asking again about her Levemir.

Thanks again
 
@Rach85 Sorry but that care plan sounds ridiculous! She should be tested when it needs doing not according too the school break times. Put your foot down and tell them that!

That made me very angry to read that rubbish about not disrupting lessons! It takes seconds.
 
My son has breakfast at 8am and is tested at 10:50am school breaktime. Like yourself later than the recommended 2hrs after eating.

The problem we had was that he was high at this reading then hypo at lunch. We had to switch it in the care plan that he had toast at break like the others (unless he was over 14, so at 13.9 he would eat) so that come lunch-time he was between 4-7.

I found that the whole school readings would depend on that first break reading. It would knock-on the rest of the day as the teachers had to follow the care plan rather than a parents sense.
 
My 9 year old is tested at 10 am - as thats about 2 hrs post breakfast ...office just go and get her (and the other diabetic child) and again at 2pm as well as the usual lunch one. Thats what the dsn asked for ..
 
chris lowe said:
It must be incredible worrying for you & scary for your daughter. I can't offer any advice but there is a whole section on the forums for young diabetics & for parents, so you may find some help there.
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Hi, my son was of 14yrs was diagnosed just over a year ago and i found that if i lowered his does of levemir at night time by 1 unit, he then does not have hypos or does he need a snack. The nurse did not tell me to do this but when i told nurse them they said it was ok. I find im alway adjusting how many units my son has depending on how his levels are especially if hes been very active or having a growth spurt. Good luck with it all the thing i have learnt is the amount of units taken is alway changing.
 
Hi there I no you posted this a while ago just wondering how you are getting on now my daughter is 8 diagnosed at 17 months we went thro the same thing we did everything they told us to do and it either made her run high or to low but as time went on we started to adjust insulin to suit are child and what she wanted to eat no to people are the same what works for one doesn't always work for someone else having said that no two days are the same neither this condition definitely keeps you on your toes I am constantly changing my daughter insulin to suit her needs
 
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