Stressful day for Type1 son.

[Calhay2010]

Day 21 of my son being diagnosed as type 1 diabetic and with doctors consent he tried his first swim session since diagnosis. All good until we were leaving then within seconds he was unresponsive on the floor. Even after glycogel given still unresponsive. My first ever phone call to 999. Then as he began to come round he was violently sick. Paramedics gave him all clear to come home but then do I give him food and he had missed his lunchtime insulin dose?? Now on the second hypo of the day and although not as bad as before it's still taken 30 mins to go up to a normal level. All very scary to see your child so poorly and I'm feeling very confused. Wish I could take it all away from him

 

[Scott-C]

The first year is probably the worst because not only are you trying to learn the rules of the game, you've also got the honeymoon period kicking in so that while you're trying to figure out the right amount of insulin for a certain amount of food, your pancreas then decides it's had a bit of a rest and starts squirting out insulin to throw your calcs out.

But that will pass. Hypos are never pleasant, they will still happen no matter how careful we are, but if it's any small comfort to a parent, they're not painful and the worst which will usually happen is that we come round thinking that wasn't much fun. I've found that when I try something new, a job, hobby, sport, whatever, I usually learn more from the mistakes than from getting it right. Your boy has now learned that exercise lowers blood sugar, so that while he might take X units for a meal one day, he should take a smaller amount the next day if he's going swimming. There's no easy answers to all of this, but all of us usually reach a point where we're sitting down to have a meal and we'll say, ok, based on what's happened in the last day and what I expect to do in the next few hours, I reckon X units will cover it. Takes a while to figure out the variables, and I sure as hell still make a lot of mistakes even after 28 years, but it's totally do-able. Embrace the mistakes as a learning experience!

 

[azure]

Sorry to hear that @Calhay2010 Its hard to spot approaching hypos early on - especially after exercise or when out.

How quickly did he drop? What was his BS after he dressed? What did he do re food and boluses before getting in the pool?

Don't worry about the vomiting. If he was given a glucagon injection that often causes vomiting.

Watch him closely, test frequently, and speak to his DSN if you have any concerns.

 

[Calhay2010]

He swam at 12pm for an hour but was late having breakfast (10.30) and he had 2 biscuits before he went into the pool. When he came out he tested and was 6.3 and he felt fine. It was approx 25 mins later as we were leaving he developed severe stomach cramps and went to the toilet. He tested in the toilet and was 5.5 but within about 3 mins he had reduced to 3.5 and had become unresponsive. With the help of the lifeguards we got him out of the toilet and he collapsed on the floor. We tested about 5 mins later and he was 4.4 then 5.0 but still unresponsive so paramedics were called. He had another hypo before bed last night which lasted half hour so had toast before he went to bed and is 10.2 this morn. I feel so confused with it all

 

[azure]

That sounds strange @Calhay2010 Its possible his blood sugar was dropping really quickly even though he was 5.5. I've had that before - a feeling of going hypo but a normal blood sugar. I've then dropped, so my fingerprick test was obviously behind my internal body.

It's also possible he may be coming down with something like a tummy bug. That can cause sudden lows as the stomach can't absorb food properly so the blood sugar can drop. The fact he was "unresponsive" at 5 suggests that may be a possibility.

Keep a very close eye on him today. Test lots and don't be afraid to test again within a short time if he feels at all funny. Watch out for any tummy issues too. Something like Norovirus can cause faintness, co icing and sudden drops, and can come on very quickly.

Assuming it's not an illness, next time you could try a shorter session - maybe 30 mins - and start off with a higher sugar and a snack that's a mix of fast carbs and slower ones eg a flapjack or a sweet chocolate bar eg a caramel bar. If I've had a busy swimming session, I sometimes need to eat when I come out too, so next time even if he is 6 when he gets dressed, you could consider giving him a similar snack (chocolate or flapjack, etc) to avoid any drop.

I hope he's ok. X

 

[CathP]

Oh my goodness, what a terrifying experience that must have been for the both of you. My 6 year old t1 daughter has swim lessons weekly, and it's very much been trial and error to get it right (and we're still often wrong!). Unfortunately her lesson is straight after a meal as well, which I think makes it much more likely to drop quickly if they're full of insulin. I hope it doesn't put your son off swimming, keep practising. I read this blog about a t1 swimmer yesterday and found it very inspiring.x
https://swimsulin.wordpress.com/

 

[paulliljeros]

When exercising the liver releases glucagen for the body to use as energy, which probably happens whilst swimming. Once out of the water, the liver then needs to refill the spent glucagen, and this can cause a hypo after the exercise. During this time, the liver will dump the glucagen to counteract the hypo, and once recovered, sometimes up to 24 hours later, further hypos can occur, as the liver tries to refill, once again. It varies from person to person, but I usually reduce insulin doses after hypos, and monitor BGs more closely for 24 hours after.

 

[justadad]

Hi @Calhay2010. My son was diagnosed over a month ago. He quit his football practice just before he was diagnosed, but nothing to do with diabetes. Even though he is not as active as he was, his BG does drop, almost on a daily basis, and sometimes goes as low as 3.0 or 3.1. His endocrinologist said it was due to his remission. Now, I am not qualified to offer any advice, but might this be the case with your son? Have you adjusted insulin doses since diagnosis? How about low BG before today?
Take care.

 

[Calhay2010]

We've had daily hypos since day one and we are on the 3rd change of dose of insulin. Totally get that it's trial and error til they work out what works for him. It's just horrible seeing him lying in the floor in a pool of sick. You feel so helpless. I've been reassured by his nurse that we did everything right and they are looking into a different monitor that will help him with his exercise. At the mo he is ok today. Regular texts coming from school

 

[justadad]

Looks like he's recovered from it like a champion.