# Low low low



## Fandange (Jan 8, 2011)

Hi All,my 10yr old has been low all morning. I have tried mini cokes, lucozade tablets, and glucogel and still can't get him up above 4. Does anyone have any suggestions??????Thanks


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## Northerner (Jan 8, 2011)

Hi, can you think of a reason for the hypos? What insulin regime is he on? The best treatment is some fizzy, sugary pop as this will empty from the stomach the quickest. How often are you testing? Be careful not to overtreat by testing too soon after administering the sugar. I've had a couple of hypos like that and all you can do (or what I did) is keep having frequent small amounts of sugar - my preferred treatment is Jelly Babies, one sweet is about 5g carbs.

Hope he is feeling better soon - watch out for more hypos in the next 24 hours as they are more likely after a hypo like this.


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## Fandange (Jan 8, 2011)

We have been testing about every 15 mins, which is usually enough for the sugar to kick in. He has just come up again, thankfully but has been having more frequent hypos over the last few days. I thought it could have been extra activity at school. I'll drop his lantus back a unit tonight and see how he goes over the next few days.
I was very interested to read the thread on blood sugars. We all seem to get different advice on management. I think I have been more inclined to toe the line because it is my kids with the condition, but I have been wanting to learn more about self management for a while now. I think I came to the right place.
Thanks


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## Northerner (Jan 8, 2011)

Extra activity will certainly do it! I've had about ten hypos this week after starting running again after a bit of a layoff, including 5 in one day! I've been reducing insulin, but still not quite enough, it seems. Lowering the lantus sounds like a good idea - I've been lowering mine too and have dropped 30% over the past week.

Are you aware of the book  Type 1 Diabetes in Children, Adolescents and Young Adults by Ragnar Hanas? It's considered to be the 'Type 1 bible' and covers just about everything you need to know - well worth getting hold of a copy if you haven't already got one


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## Fandange (Jan 8, 2011)

Thanks, Northener. Funny you should mention that book, it is one of four I have borrowed from the library this week! Will move it to the top of the pile after your recommendation. 
Luckily for Bede (10 yr old), his brother has a clinic appt on Monday so I can take his info in as well. Although, I sometimes get the feeling that the nurses are as baffled as I am.....
He has just gone low again......but lunch might help!


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## Northerner (Jan 8, 2011)

It's an excellent book and not just really for children and 'young' people - I was 49 when I was diagnosed! So much for 'juvenile' diabetes! 

How much lantus is he on? I've been down as low as 3 units (I was originally put on 20!) and when you get down to that kind of level it's very difficult to make adjustments because just 1 unit means a difference of 33%! Of course, it's a lot tougher to predict with children as no doubt you already know.


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## Fandange (Jan 8, 2011)

He is on 14 at the moment. Would you go down by one unit at a time?


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## Northerner (Jan 8, 2011)

Fandange said:


> He is on 14 at the moment. Would you go down by one unit at a time?



I think the normal recommendation is no more than 10% at a time, so 1 unit would be appropriate. Also, it's recommended with lantus that you allow two or three days to see the full effect of any adjustment. What are his waking levels like?


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## Fandange (Jan 8, 2011)

Up and down. He was 15.3 when he woke up this morning, but he did eat an enormous meal last night. We had a couple of weeks of good contol until about 3 days ago. If he is low before a meal, I generally take of 0.5 on his meal dose. Not sure is that is recommended but it makes sense to me. He seems to be growing right before my eyes at the moment, too. We'll try dropping the lantus tonight.


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## bev (Jan 8, 2011)

Hi Fandange,

Hypo's breed hypo's - so the best thing you can do is to run Bede higher than normal for a day or two at least. Probably the reason that he has been low all day is that his liver has run out of stocks and is struggling so he will need to replenish his liver with lots of carbs. I wouldnt 'correct' unless over 15 or so for a couple of days otherwise you are in a spiral of hypo/high. I am thinking that the high this morning was the start of it and he possibly had a hypo in the night which in turn started the whole cycle. I hope he feels better soon and I would definately drop his lantus by one or two units tonight.Bev


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## Fandange (Jan 8, 2011)

Thanks. Bev. He has  been low since straight after lunch but is okay again now. Poor little guy says he feels sideways, rather than up and down.....
I'm grateful to have you guys to talk to about it! Takes some of the guess work away


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## Fandange (Jan 9, 2011)

Just to let you know how the day finished.... Bede was low before his dinner tonight, we got him up into range and he tested before bed. Hooray 7.6. Poor little love, I went in at 1030 and not even a finger prick woke him up. Happy to say he was 11.6.
We took your advice and and dropped the lantus by one unit.
Again, thanks for your advice and support. Experience is one of the best reassurances. Take care of yourselves


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## Northerner (Jan 9, 2011)

Fandange said:


> Just to let you know how the day finished.... Bede was low before his dinner tonight, we got him up into range and he tested before bed. Hooray 7.6. Poor little love, I went in at 1030 and not even a finger prick woke him up. Happy to say he was 11.6.
> We took your advice and and dropped the lantus by one unit.
> Again, thanks for your advice and support. Experience is one of the best reassurances. Take care of yourselves



Hope he wakes to a good level


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## bev (Jan 9, 2011)

Hi Fandange,
How are things today.Bev


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