# consultant comments treating hypos



## hkk1970 (May 26, 2013)

Hi, I would appreciate your comments. My little boy Harry is 4 and has been on hid pump for 3months now. Due yo his fluctuating and unpredictable levels through the night , I test him frequently thru the night. I treated him for a hypo when he was 3.9 and had to wake him. The consultant said that I shudnt have woken him up nor treated the hypo. I was told to leave him unless he woke up. I was horrified,,have I over reacted? His diabetes is a constant worry to me and this only made things worse.


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## pgcity (May 26, 2013)

I wouldn't always treat a 3.9 if I had no symptoms as meter error may mean it wasn't a hypo. I would test again in 15 mins or so to see what was happening.

However I would always treat in the night as I don't always have the same physical symptoms as I am lying down.

I would do whatever caused you the least worry.


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## bev (May 27, 2013)

Hi Hkk1970,

I wouldnt accept that as good advice at all.If you accept that meters can be out by as much as 20% then it is conceivable that the 3.9 was actually lower! Especially as your son is young and may not be able to explain to you how he is feeling! Our team say ALWAYS treat if 4 or under - whether it is day or night - because you dont know whether they are on their way down even further and many children DONT have hypo symptoms at night - so why would you take the risk? Go with your instincts and do what feels right for you. Assuming you dont over-treat a hypo by giving slow-release then in my opinion you are doing the right thing. It would be interesting to know whether the Consultant would ignore a 3.9 during the night on his own child..........Bev


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## Pumper_Sue (May 27, 2013)

hkk1970 said:


> Hi, I would appreciate your comments. My little boy Harry is 4 and has been on hid pump for 3months now. Due yo his fluctuating and unpredictable levels through the night , I test him frequently thru the night. I treated him for a hypo when he was 3.9 and had to wake him. The consultant said that I shudnt have woken him up nor treated the hypo. I was told to leave him unless he woke up. I was horrified,,have I over reacted? His diabetes is a constant worry to me and this only made things worse.



You have not over reacted, you did the right thing. If the 3.9 was before a meal then no I would not correct. Night times I always correct at that level.
Well done that Mum.


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## HOBIE (May 27, 2013)

Just reduce basal on pump without waking him. Easy to do on a medtronic.


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## Pumper_Sue (May 27, 2013)

HOBIE said:


> Just reduce basal on pump without waking him. Easy to do on a medtronic.



That's all very well but it takes an hour for the reduction to work so if the little chap was going down, what then?


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## bev (May 28, 2013)

Pumper_Sue said:


> That's all very well but it takes an hour for the reduction to work so if the little chap was going down, what then?




Hi Hobie,

I agree with Sue here - it isnt appropriate to just reduce basals as it would take too long to take effect and the child could be heading towards a low hypo untreated.Bev


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## Redkite (May 28, 2013)

hkk1970 said:


> Hi, I would appreciate your comments. My little boy Harry is 4 and has been on hid pump for 3months now. Due yo his fluctuating and unpredictable levels through the night , I test him frequently thru the night. I treated him for a hypo when he was 3.9 and had to wake him. The consultant said that I shudnt have woken him up nor treated the hypo. I was told to leave him unless he woke up. I was horrified,,have I over reacted? His diabetes is a constant worry to me and this only made things worse.


Hi, some consultants still believe in the theory that a child will wake when hypo (mine never has) or that their liver will "rescue" them by releasing stored glucose.  Unfortunately that isn't always the case, and in a small number of cases severe nocturnal hypoglycaemia lasting several hours can result in a fatality.  No parent wants to risk such a thing, and you are quite right to test at least once during the night and treat a hypo if you find one.  In fact, if my lad is down in the 4's I would consider waking him for some lucozade.  I have tried the alternative (turning his basal down for an hour and staying up to retest) - and 9 times out of 10 he will be lower after that hour.  Until they have lived with the condition themselves, consultants shouldn't pontificate in such a high-handed way.  You're doing a great job!


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## everydayupsanddowns (May 28, 2013)

I think you are handling that perfectly HKK

If I test during the night at 3.9 (or anything below 4.5 really) I would certainly have a swig of lucozade.

I have woken up at night for hypos, but only quite rarely tbh. On at least as many occasions I've woken by alarm for a test and discovered myself already low.


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## hkk1970 (May 28, 2013)

Thanks for your support once again. I often think if doctors and the specialists would feel the same if it was their child..
The consultant last week increased his basal by ten per cent and increased his carb ratio and we have had 2 hypo every day since. I have changed his carb ratio back down a bit to see where we go in next few days.


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## bev (May 28, 2013)

hkk1970 said:


> Thanks for your support once again. I often think if doctors and the specialists would feel the same if it was their child..
> The consultant last week increased his basal by ten per cent and increased his carb ratio and we have had 2 hypo every day since. I have changed his carb ratio back down a bit to see where we go in next few days.




Hi Hkk1970,

Its a worry when a team change two things at a time. Most teams would advise one change for a few days before making the other change as it can muddy the waters and you might not know which change has made the impact! Its great that you have over-ridden the decision - that shows your getting a real feeling for the right thing to do with your child - *knowing* when to make changes on your own is key to getting good control.Bev


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## Fettuciniuse (May 28, 2013)

Reckon you did the right thing.  

I would definitely treat a reading under 4 as a hypo.  In fact I would wake my son up for anything around a low 4 to give him some milk. (lucozade for under 4 though).

There is a fine line between being paranoid,  and taking your chances.  I know which one I'd rather live with.


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