# First ever hypo and its bed time



## Lilmssquirrel (Aug 5, 2020)

Just given her 150ml appletise and peanut butter on toast. Would you test in the middle of the night too?

TIA 

Anxious Mum


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## Thebearcametoo (Aug 5, 2020)

How low was her hypo? What have her numbers been all day? Can you see an obvious reason for the hypo (more exercise, didn’t eat all of dinner, some foods may be more likely to cause hypos - rice for my daughter, pasta for some people). Is she normally fairly stable overnight.

If you’re concerned then test her when you go to bed and see then what you think about night time testing. I tend not to do it. Some people always test overnight. 

The first few hypos are scary as you just don’t know how they’ll react but you get to have a feel for what sort of a hypo it is and how hard it is to treat etc.


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## Deleted member 27171 (Aug 5, 2020)

I would say, if you’re feeling anxious then yes as you probably wont sleep too well if you don’t anyway.
Or, you could try testing before you go to bed (assuming that’s  not too soon) and see how she is then?


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## Lilmssquirrel (Aug 5, 2020)

Thanks for the quick replies. Today is the first day she's been in range consistently and was also at sports camp. She was wobbly at 4.7 in the afternoon so they gave two dextrose and a cereal bar and she was back up at 6.6 after. Before tea, 6.3 and after 5.5. Then legs were shaking 30 mins later so we checked and 3.8.

Hypo treatment completed and back to 6.6 after appletise but before toast. 

I will check her again at 11pm.

Thanks ladies xx


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## Deleted member 27171 (Aug 5, 2020)

All that added exercise could well cause a reduction in basal needs for a while after - given she’s dipped backed to hypo a few times today, 11pm check is a good shout


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## Thebearcametoo (Aug 5, 2020)

Has your team given you advice for exercise?

It sounds like she has good hypo awareness which helps. If my daughter has a hypo at bedtime she tends not to be able to sleep so we catch it. I don’t think she’s ever woken up with one in the night but she’s generally stable overnight.


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## Lilmssquirrel (Aug 5, 2020)

@Thebearcametoo I'm sure they did give advice but my head is literally spinning from all the info. Regular checks and snack if low from what I remember. I am due to speak to them tomorrow to update them as we've had probs with a three point rise overnight so fingers crossed she'll be okay overnight.


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## Thebearcametoo (Aug 5, 2020)

Rising overnight may work in your favour today.

and yes there is so much info to begin with. Sometimes it’s about having the data to be able to give advice too so it’s not that you’ve done anything wrong. It’s all part of learning (and good management will mean more hypos than if she’s running high all the time, some hypos is a normal part of diabetes management)


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## SB2015 (Aug 5, 2020)

Lilmssquirrel said:


> Thanks for the quick replies. Today is the first day she's been in range consistently and was also at sports camp. She was wobbly at 4.7 in the afternoon so they gave two dextrose and a cereal bar and she was back up at 6.6 after. Before tea, 6.3 and after 5.5. Then legs were shaking 30 mins later so we checked and 3.8.
> 
> Hypo treatment completed and back to 6.6 after appletise but before toast.
> 
> ...


I know that you have had problems with a late hypo today, and already seen some good advice. 
But I just wanted to say well done to both of you.  What struck me from your post was that those  levels are amazing through the day for someone so recently diagnosed.  You are both doing brilliantly.  

Having done lots of exercise during the day DD will be needing to top up the store of energy so levels will drop a bit.  I find I have to reduce my insulin a bit after a full day of walking.  I don’t always remember to do it and end up in the same position as DD (and that is 12 years into this!!)

There is loads to take in at first so just keep coming back to us and your team with the questions.  We do understand and no one minds.

Well done you and DD.


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## everydayupsanddowns (Aug 6, 2020)

Sorry to read about the bedtime hypo.

Sounds like you coped brilliantly. Exercise can be a bit of a tinker for affecting glucose sensitivity for 12-24 hours following (all very individual of course!)

How did things go overnight?

If sports camp is an ongoing thing, you may need to slightly adjust basal/ratios (or ask your team for their recommendations) if the effects continue.


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## Lilmssquirrel (Aug 6, 2020)

Thanks again everyone.  She went to 6.4 at 11pm so I managed to sleep from 11.30 til 4pm (when the dog woke up choking!) so i popped in to check all was well with her.  She was then 7.5 at breakfast so the glucose going up overnight was a good insurance policy (for now)

I'm due to call the team today so am armed with a list of questions to be reminded what to do about sports camp.  Last week we had the luxury that she was still above range on most of her readings so didn't have to worry.  I wonder if maybe next week if she's in range at tea time whether I give her an extra carb snack before bed...but will check in with the team

Am so lucky to have found this forum to help me navigate through all of this


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## trophywench (Aug 6, 2020)

And we're all very pleased that a) you've listened in the first place and b) that you put the new knowledge into practice and c) but should probably have been a) that your daughter is doing so very well so quickly!

Is it getting  a bit less like wading through treacle with no map?


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## Lilmssquirrel (Aug 6, 2020)

@trophywench I have a dog eared copy of "Feel the Fear and do it Anyway". I'm one of those people who spends way too much time worrying about what could happen months in advance which is why my grandma always told me not to try crossing bridges til I got to them and why I'm an excellent project manager.

The one thing I've never figured out is how someone who worries so much can walk out of the house without a bag containing the kitchen sink? But now I've got one of those, life is good!

A little less treacly and a bit more path ahead showing

Thanks again xx


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## trophywench (Aug 7, 2020)

I own several handbags I happily term my pantechnicons, and I did always use an A5 diary to keep track ...... especially right now, I have difficulty knowing immediately what day of the week it is - when you do bugger all every day for months on end and there's hardly anything worth watching on TV it tends to merge.

Thank the Lord we've got some things to be doing from next Monday onwards, to try and get myself wound up  (like clockwork I mean not stress) and moving about.


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## Lilmssquirrel (Aug 8, 2020)

Morning

Me again. So yesterday was hypo city 

She went out with hubby and had one mid morning. Then (the idiot) bought her a jam doughnut which I let her eat with tea. I probably should have split the bolus as two hours later she was 3.6 so we treated that and she went to 6.6. I checked again at 10.30pm and she was 3.8 so we treated again.

This morning 7.4 on waking and then 8.6 by breakfast. 

I know the heat also plays havoc with insulin but as that's the third hypo night in a row, I wondered if I should tweak the teatime ratio? She was 1:7 when she left hospital but in the early days as she was still high, they changed her to 1:6 at teatime.

Would it do much damage to go back to 1:7 for a few days? The nurses were talking to me about tweaking myself this week if I felt it was right but I am still a little nervous. I'm presuming a change of one won't send her sky high again? 

Would appreciate your thoughts.

Xx


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## Pumper_Sue (Aug 8, 2020)

I think you will find that DD is going through what is known as the honeymoon period. This means her pancreas is having it's last final fling (party time  ) before it stops spluttering. So I would suggest you look into cutting back her background insulin and perhaps then just correct when needed with her bolus insulin.
PS. there's nothing wrong with a donut  hope it was enjoyed.


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## Deleted member 27171 (Aug 8, 2020)

Sounds like a good plan to me   and like the nurses are encouraging it, so why not give it a go?

Since it‘s mostly evenings with things generally settling overnight, reducing tea time insulin seems like the logical thing to try, at least to start with. 

It is all still a bit of trial an error so if you find that she starts to rise again, you can always make further changes. Could even be something that she needs if she’s had a very active day but doesn’t on others so worth keeping a note of that stuff too so you can look back and see if there’s any correlation with post dinner levels.

You seem way more on top of it than I was at this stage - a little bit of caution and double checking is understandable but certainly looks like you know what you’re doing from where I’m sitting!


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## Sally71 (Aug 8, 2020)

Changing it by one is often all you need, and if it sends her too far on the other direction you just change it back again.  Everything is reversible!  In fact I seem to spend half my life tweaking my daughter's pump settings.  It's something you'll have to get used to, so go for it!

Very likely the heat has got something to do with it, my daughter is hypo a lot at the moment and I’m having to adjust everything down, quite likely next week it will all have to go up again, such is life!


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## stephknits (Aug 8, 2020)

My daughter has been having more hypos in the last few days.  I think it's a combination of the heat and her pancreas working.  Am contacting the team this morning and will be looking to reduce insulin.


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## Lilmssquirrel (Aug 8, 2020)

Pumper_Sue said:


> I think you will find that DD is going through what is known as the honeymoon period. This means her pancreas is having it's last final fling (party time  ) before it stops spluttering. So I would suggest you look into cutting back her background insulin and perhaps then just correct when needed with her bolus insulin.
> PS. there's nothing wrong with a donut  hope it was enjoyed.


I was just gutted I couldn't have a bite of the doughnut as I had already bolused it


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## Lilmssquirrel (Aug 8, 2020)

Thank you everyone. She's hypo again now so we are going to tweak lunch and see what happens this afternoon. Xx


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## SB2015 (Aug 8, 2020)

Lilmssquirrel said:


> Thank you everyone. She's hypo again now so we are going to tweak lunch and see what happens this afternoon. Xx


You are sounding like a pro already.
Well done


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## SB2015 (Aug 8, 2020)

Lilmssquirrel said:


> I was just gutted I couldn't have a bite of the doughnut as I had already bolused it


Think how much DD is helping you to avoid temptation.

On a more serious note the tweaking will go on, and the honeymoon period does make this more necessary, but it will just be part of ‘normal life’ now.


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## Thebearcametoo (Aug 8, 2020)

Tweaking is normal.

If she’s having a lot of hypos and not much else has changed then it may be the basal that needs dropping but have a chat with your team. A lot of the early months of diabetes is data gathering so getting to know how she reacts to heat, exercise, certain foods etc and you will eventually reach the point where you know which foods to underestimate carbs on or which need earlier insulin or which activity will cause her to crash. But honestly even when you have a lot of data there will still be days where it all seems to go pear shaped.
And no problems with a doughnut. We would always try to have it with a meal (with some fat and protein) rather than on its own but she can eat anything.


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## Lilmssquirrel (Aug 8, 2020)

I never in my life dreamt that I'd become a virtual pancreas as a career!  What a fine piece of biological engineering a real one must be.  The body is truly amazing (and equally blooming stupid for destroying such a useful bit of kit!)

Ref the doughnut - I'm less worried about the carbs and more worried about the wrath of the dietician. She seems to think its me that undermines healthy eating because I run a cake business but in actuality, it's always been hubby, the ex hubby, my mother and my friend who is a paediatrician(!) who have been the worst culprits. I'm a well known bad cop on the food front in this house  but hoping the better diet will do me good too as it's keeping me away from the savoury snacks.

@SB2015 I'm just jealous as he'd never buy me a doughnut 

@Thebearcametoo I think ultimately my biggest frustration will be the total randomness of the body's behaviour or me not being able to correctly triangulate all of the various influences on the blood glucose to figure out the correct dosing.  I guess life will never be boring from now onwards.


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## Thebearcametoo (Aug 8, 2020)

Nah life is all about riding the wave of guessing the carbs in something and being spot on 

You don’t have to prefect. It’s about being good enough for enough of the time that HBA1C results are all pretty good and she still feels like she has a normal life. The thing about diabetes is it’s very much about what’s happening in that moment. If there’s a hypo you treat it and everything else pauses for those few minutes. If you can stay mindful and in the moment of what needs to happen now instead of stressing about the whys and what might happen then it actually helps you cope with the rest of life’s ups and downs too.
Obviously pattern emerge and we learn which foods are more likely to be tricky etc but staying in the NOW helps keep everything in perspective. I have a very close relationship with my daughter because of all the time we sit together waiting for hypos to be sorted or dealing with all the big feelings about diabetes. I would love for her not to have it but our relationship is good because of how we’ve had to cope with it.  
(Our dietician is tiny and cycles everywhere, teaches yoga and is the paragon on virtue when it comes to what she eats. She is however good at saying that no food is forbidden just look at portion sizes and frequency and to try to have meals rather than grazing. But she is a bit intimidating! )


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## Sally71 (Aug 8, 2020)

She's not a very good dietician if she doesn’t allow your child to have the occasional treat.  My daughter has never forgotten a meeting with the consultant 3 months after diagnosis, when the consultant said “if you want doughnuts, eat doughnuts!”  Daughter has always said “I love Dr. R, she says I can eat doughnuts!”  Of course she didn’t mean that it's ok to scoff food like that every day, but she was making the point that you can have a treat occasionally if you want one, as long as you count it and bolus correctly.


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## trophywench (Aug 8, 2020)

Exactly, Sally!  One thing I think about diabetes in general occasionally and this is one of those times - it never kills anyone faster than a speeding bullet, does it?  Hence whilst we may sometimes act in haste, we usually have more than enough time at leisure to repent afterwards, don't we?    

The other unfathomable thing about doughnuts generally, is of course how they are cooked.  Deep fried - all adds to the scrumminess of the things ...... hang on a minutes, so it's a gurt lump of dough plunged into the deep fat - so how much of that fat has it absorbed whilst cooking?  And so - how can anyone work out at what speed the carbs in the dough (let alone the jam) will hit their bloodstream?

Far better (diabetically and if I want a treat) IMHO to go for a fresh cream eclair EVERY TIME!


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