how low BG ?

[Matt1212]

How low can your BG get to and still be able to function ?
Our little girl aged 5 tests her own BG before morning snack at school and came home with a 0.9 reading yesterday
I found it hard to believe it is accurate
However the two previous days she was 3.5 then 3.1 so we have changed her morning carb ratio.

Could she really be so hypo unaware as to be able to function at 0.9 ?
You can normally tell by her mood when she hits the 2’s.

Thanks
Matt

 

[Geoff]

Hi, the general rule of thumb that is safe for day to day living is 4.0mmol/lt this is considered to be a normal non diabetic level. Anything long term below this is an accident waiting to happen. If your little girl takes her own blood tests, encourage her to take them more often so that she can react to any level below 4 quickly, this will help her learn and feel what the warning signs are.

Remember this saying "4 is the floor"

 

[jameshallam]

I have never been below 2.7 but...

Although once, after playing squash i tested myself and the meter just said 'LO'.
I thought it said 1.0, so i took 6 jelly babies and was worrying quite a bit.

When i got home, I tested again and was at 8.5 - so i thought something must be wrong, so i checked the meter (this is when i found out it said 'LO' not 1.0). After checking the manual it said that anything under 0.6 will be displayed as 'LO'.

I'm pretty sure that i was never as low as 0.6 - I didn't feel any of the symptoms (normally feel anything under 3.5). My fingers were pretty sweaty so i thought there must have been some kind of error when i tested.

Also (I have a Bayer Contour Meter) sometime the blood doesn't get completely 'sucked' up the testing strip and sometimes still displays a result (it is meant to display an error when there isn't enough blood). This has caused an error of up to +/- 5mmol/L.

Hope that helps
James

 

[cugila]

Matt1212 said,

How low can your BG get to and still be able to function ?
Our little girl aged 5 tests her own BG before morning snack at school and came home with a 0.9 reading yesterday.

I am sure when the Mom's and Dad's on here get around to this you will get more answers.

To me I would want to get this checked out with your HCP, I have no idea if it is normal or not at 5 yrs old and wouldn't dream of offering an opinion.

This from Wikepedia.
Children's blood sugar levels are often slightly lower than adults'. Overnight fasting glucose levels are below 70 mg/dl (3.9 mM) in 5% of healthy adults, but up to 5% of children can be below 60 mg/dL (3.3 mM) in the morning fasting state.[14]

As the duration of fasting is extended, a higher percentage of infants and children will have mildly low plasma glucose levels, usually without symptoms. The normal range of newborn blood sugars continues to be debated.[5][6][7]

It has been proposed that newborn brains are able to use alternate fuels when glucose levels are low more readily than adults. Experts continue to debate the significance and risk of such levels, though the trend has been to recommend maintenance of glucose levels above 60–70 mg/dL (3.3 to 3.8 Mm) after the first day after birth.

The full article is here:
http://en.wikipedia.org/wiki/Hypoglycem ... ifferences (not verified)

 

[SophiaW]

Was the test redone to make sure? If I get a reading that doesn't make sense I always do another one straight away just to make sure. Have you done a control test on your meter? We use the Accu-Chek Aviva meter and you can get control fluid to test that your meter is giving accurate results. Check with the manufacturer of your meter, our one lets us order consumables over the internet for free. I don't recall what Jess' lowest reading has ever been, it was either high 1s or low 2s and she was very clamy and what we call "floppy" i.e. no energy, just wanting to flop down and sleep. Try to avoid getting readings lower than 4 on a regular basis, the more often this happens the more your daughter is likely to lose hypo awareness.

 

[SophiaW]

Reading your post again, you say that your daughter tests herself. Does an adult look at what the result is and make sure that any hypos have been treated accordingly? I've asked staff at our school to always check with Jess what the test result reads. What would happen if it's really low to the point that she can't function properly and doesn't think to treat her hypo. If she wasn't able to function to treat her hypo, and staff didn't notice, it would be left and I think that would be dangerous.

 

[kegstore]

The lowest I ever (knowingly) got was 1.2, unconscious and fitting. The only reason I know this is the A&E nurse told me. I have tested myself at 1.9 but was barely capable of doing very much at all. Dangerous territory to be in. Is it different for young children?

 

[Debloubed]

I would imagine that adults and children alike, anything below 4 is cause for concern (with type 1) and anything below 2 is a bit on the scary side. I must say however, I am very impressed your 5 year old tests herself, what an angel! But is it possible she is not using enough blood? although that would probably give an 'error' reading........I find that it depends what I am doing as to how I react to a below 3 BG, if I am asleep, I will fit to wake up but I have tested at 1.2 and been upright and lucid and quite frankly a bit freaked out to read the 1.2!! and yes, I re-tested. How long as she had diabetes? could she be unaware? lots of questions for your next call or visit with your DN

 

[Matt1212]

thanks for all the replies
My daughter has only just started to test herself (diagnosed 1 yr) and the main reason was so we could
try and confirm that her BG was OK mid-morning – it would appear it is not so hence the ratio change at breakfast
Next step will be to try and get someone to interpret the results at the school as she is not really ready for that.

Maybe children can function at lower BG but I guess it is not a good habit to get into
I think I am guilty of under treating hypo’s and not giving extra snacks when it is cold or she is playing a lot
In an effort to avoid later spikes

Took me around 1hr 20 mins to get her above the 2’s at the park last week so I should learn my lesson to treat any sub 4 as
hypo and not attempt to give minimum fast acting to bring her back up

Do we people treat a 3.9 the same as 2.9 or a 1.9 (I guess adults can assess themselves if they feel low?)

 

[phoenix]

Three times I've had a 'lo' on meters (less than 1.1mmol) and each time I've been able to cope at these (supposed) levels.
Once I was on a skiing machine. I felt I was becoming a bit unsteady, tested, took a couple of glucose tablets and was back on the skiing machine within a few minutes with no problems. As that activity requires both balance and co-ordination I think I was fully functional.
On another occasion I knew I was low, and wandered round and round Boots looking for a packet of dextrose to buy, even though there was some in my handbag. So that time my brain was definitely a bit befuddled .That time I tested after I'd taken the glucose and had a shock to see 'lo' when I thought I was recovering.
Perhaps some meters are not that accurate at these lower levels.
Nevertheless even though I managed to function at these supposedly low levels I did take it as a warning sign. It's not a good thing for any of us to have frequent hypos for all the reasons others have mentioned. I think that you should discuss these frequent lows with your doctor/nurse.

 

[bazippy]

I have been completely able at a blood sugar of 0.9 dont get me wrong i know i was low, infact im very sensitive to lowering blood sugars but i have never collapsed and am still completely able in really low situations. i find it weird that person above my post was freaked out at 1.2 but i think thats more my problem with been too complacent with low bm's.
it seems a very subjective thing, i once met a diabetic who was on the floor at anything under 3 whereas me ive never got close to collapse.

 

[suzi]

Hi Matt,
Insure your daughters teacher looks at her bs readings, and treats anything below 4 as hypo, even a 3.9 can continue to drop if left untreated. Always treat a hypo with fast acting glucose (we always use lucozade) and follow it with a slow acting carb ie biscuit.
Its a good idea when heading to the park and knowing how energetic 5yr olds can be, by giving her a mini milky way or something similar for energy, she'll soon burn it off and it should stop her from going hypo.
Andrew my 11yr old, experienced his worse hypo at home 1.0 and it took about an hr to get his bs back to normal, he was ravanous and extremely tired.
If your daughter's bs is tightly controlled at present, she may have lost her hypo awareness ( this can happen), it may be useful to let her bs run a little high for a couple of days, then if she hypos you should find her hypo awareness returns. Like everything diabetic, in children its all trial and error.
Suzi x

 

[kegstore]

Just thought of one thing that hasn't been mentioned, the importance of retesting after 20 minutes or so (having treated the low). The test is a snapshot only so it's impossible to know in which direction it's going on the basis of a single test.

I do treat a 2 more aggressively than a 4, but always very careful not to overdo it.

 

[SophiaW]

I don't think children are any different from adults with low readings, but I do think people (child or adult) are all different depending on the individual and when some can cope at a reading of 2 others may not be able to. If Jess hits anything below 2.9 I can see she is beginning to struggle, her co-ordination is not good at that level and she tends to drop the meter and fumble around to get the test done.

How I treat a hypo depends on when the hypo happens. If her Novorapid has just about worn off from the previous meal then I know although she's low that her reading isn't going to continue in a rapid drop because most of the insulin effect has worn off. This I'll treat gently and always retest in about 15 minutes to make sure her reading has recovered and holding.

If she is hypo and her Novorapid is still in full swing then I'll treat the hypo more "aggressively" as I know that she will not only need enough to bring her out of hypo but also to cope with the effects of the Novorapid until it has worn off.

I always, always do a retest 10-20 minutes after treating the hypo to make sure her blood sugars have recovered and stabalised.

Matt, if you don't treat a hypo (anything below 4mmol) quickly or your daughter is regularly having hypos then your daughter will in all likelihood lose hypo awareness and that is not much fun, it really is a blessing to have the hypo awareness there.

 

[leggott]

Hi, It might be worth asking the school to give you a call if they get reading is very low. We have asked our school to call if my children get a reading below 2.5, or above 15 . This just gives us the opportunity of deciding what the best course of action is. My son once had a reading that low (shortly after diagnosis), and he was acting perfectly normal and felt fine! Other times he can get a reading of 4 and say he feels funny and thinks his sugar is low, with children that age things just seem so erratic at times.

 

[Jen&Khaleb]

I once tested and got a LO and treated it swiftly (it was 2am and he was asleep). After 10 minutes the test was 5. something so I actually thought he wasn't quite as low as the meter said. I think I had done a test that required me to stop and squeeze a bit more blood out and I think I changed the accuracy by doing this. He obviously needed some hypo treatment but I think he would of really been in the 3's.

Below 2.5 (only happened twice) Khaleb is sweating heavily, shaking and very upset. Anything getting into the low 4's is noticeable as far as him being pale and having a different sort of mood. Anything between this varies in symptoms and sometimes depends on the speed in which he is dropping.

I'd still treat the hypo first and retest in 10 minutes rather than waste time re-testing. If I could see he was hypo I would also treat first and test after. I read somewhere that the body can raise bs by 2.5mmol/15 minutes with glucose.

Even though '4 is the floor' I actually try to keep Khaleb in the 5's/6's if possible. I'd certainly not leave a 5 for very long before a meal/snack. I use Glucose powder to treat hypos. It is good because I can use small amounts and not get big spikes afterward. It isn't messy and I can mix it in puree food or his bottle in the middle of the night as Khaleb can't chew.

 

[sugar2]

Hi Matt,

i am far older than 5 alas, and well done for getting your daughter to do her own blood tests, you must be really proud of her!
For me, ability to unction is not always related to BG reading. During the day, I can fell a bit low, do a reading and find I am in the one point something, but at night, I seem to lose teh ability to function at a much higher level...around 3.2. For me, it seems to be the combination of sleep and BG level that has an impact.
To be honest, it sound like adjusting her carb ration sounds like the right thing to do...she dhouldn't be that low routinely.

As a Mum of 2 children under 4, I am really impressed by your little girl, and her maturity to do these tests. I agree that it would be a good idea to get an adult to keep an eye on things, but to me, putting her "in charge" of her diabetes at a young age, with the right fuidance is a greatthing to do.

 

[Matt1212]

Re: how low BG ? and how often ?

Hello All,

One final question ref this post , how often do people feel it is acceptable to have a reading under 4 ? when diagnosed we were told around 2 sub 4 readings a week would indicate that we were being aggressive enough in keeping the BG down.
If you have a hypo every other day that is 3.5 a week so not to far from 2.
Interested in anyones thoughts ?

thanks again
Matt

 

[Celtic.Piskie]

It depends why the hypos are happening. If it's related to exercise, or some other reason, then ever other day isn't bad.
If it's medication, then every other day seems too much for me. The more hypo's you have, the greater your chance of loosing hypo awareness. At such a young age, i think that every other day is too many, since many years of this cannot be good.

 

[shedges]

Every other day is considered too frequent. My nurses get concerned about my insulin dosing if I get 3 or more hypos per week. Would never want to lose the sensitivity, so if the other option is the odd 0.5% on my Hba1C, I'll take it.

As with everything diabetic, it's a balancing act!