# Hypos



## Carynb (Sep 7, 2009)

Have been struggling this weekend with hypos, consequence of being back at school and perhaps coming into 'honeymoon peroid' so I've been told. Just spoke to DSN who suggested reducing novorapid and lantus for a few days to see what happens.
Was completely freaked out at 4AM when I tested him as he was only 3 and hadn't woken up, also when I did wake him he said he didn't feel hypo at all. Really scared me as it's his first night time hypo.....
Poor boy went to school today very bleary eyed. 

Caryn


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## Adrienne (Sep 7, 2009)

Hi Caryn

Sadly this is not uncommon.   Most children with type 1 do NOT wake up at night when hypo.   This is why most of us test during the night.   It is a pain in the butt and lack of sleep is horrendous but we still test, better to be safe then sorry.

I do not wake my daughter Jessica (aged 9), if she is hypo, never have done.  She has full sugar coke to treat hypos, the small 150 ml party cans, and I open it up, stick in a straw and pop the straw in her mouth whilst I'm holding the can.  She drinks it in her sleep.  Its quite sweet really as she sucks it like a small baby sucks a bottle in their sleep.   She drinks the can in under 10 seconds and stay asleep.    I wait 15 minutes and test her again and if she is ok I go back to bed.    She is therefore not disturbed.

Please don't believe any medical person if they say your son will wake up when hypo.     My old consultant did a study on that specifically and it was determined that most do not wake up.    

I keep a box upstairs now permanently with coke, straws, a glucagon emergency kit, glucotabs, hypofit and when she goes upto bed the test kit goes up too so it is all to hand if I need it.

Reducing insulin when going into honeymoon is normal.   The honeymoon period can last a month or anything up to a year or bit more.  You will know when he is coming out of it at the other end, so don't worry that  you won't know.

Do you carb count?   You will see much better levels on MDI (multiple daily injections ie Lantus/novorapid or Levemir/novorapid) if you carb count.   If you have not been told about that, ask your DSN to get the dietician to teach you asap.

Have you looked at www.childrenwithdiabetesuk.org  it is a website written by parents of children with diabetes for parents of cwd.   It is fantastic (I'm a bit biaised though, they are all my friends )


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## Becca (Sep 7, 2009)

Carynb said:


> Have been struggling this weekend with hypos, consequence of being back at school and perhaps coming into 'honeymoon peroid' so I've been told. Just spoke to DSN who suggested reducing novorapid and lantus for a few days to see what happens.
> Was completely freaked out at 4AM when I tested him as he was only 3 and hadn't woken up, also when I did wake him he said he didn't feel hypo at all. Really scared me as it's his first night time hypo.....
> Poor boy went to school today very bleary eyed.
> 
> Caryn



Hi Caryn

As Adrienne says children with T1 will NOT always wake up when hypo.  Last night we tested Rose at 3am and found she was 3.4 blissfully snoring away....

As part of the artificial pancreas trials, the researchers have been astounded by the sensors and the fact that a lot  of children went hypo overnight without waking.  Intervention was needed.

Hope you're ok....


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## Mand (Sep 7, 2009)

Hi Caryn

My son does not always wake up if low. 

I give my son fruit juice with a straw if i test him in the night and find he is low. As Adrienne has said, they suck and swallow but do not necessarily wake so they are not tired the next day. I do prop him up though so he does not choke. 

Mand


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## wendyh (Sep 8, 2009)

Hi Caryn

I know....................we have the same problem - my only wee tip is.....................once he is sleeping sneak in and take his numbers - then when you are going to bed take his numbers again. This is what I do for peice of mind - nearly 4 years in and it works a treat. Mostly if I have to feed Lucy - she does not wake up - so it kind of echos what everyone else has said!
Good luck   x


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## Patricia (Sep 16, 2009)

Yes we do the same as everyone else...If we can manage, we often will test at 9.30 or 10pm when he's settling (13 yr old!), then we stay up if we can and test him two hours later. If he doesn't need a correction or isn't below 7, we are home free almost always (on the pump). If he needs a correction, we get up again an hour or two hours later (depending on size of correction) to test the correction. If he's below 7, we wake him up for juice from a box/straw (or at 9.30 he might want a biscuit and some milk), and then don't test again. 

If he's hypo, we do the same as Adrienne -- treat then test again.

If we can't make it up to 12 or 1am, we get up at 3am to test him just in case.

My son has woken up twice hypo -- both at odd times, and unexpected. We have 'caught' hypos -- two of them VERY low, in the 1s -- at night as outlined above because we have a very strict system of when to test. He certainly would not wake othewise.


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## Carynb (Sep 17, 2009)

We're now going high mid morning and then too low by the end of school day!! Going to make some small adjustments to breakfast and lunch N/Rapid and see what happens. 
Night time is better now, touch wood. He always has a bedtime snack  and Lantus has been lowered so we'll see what happens.


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## michelle g (Sep 18, 2009)

Cripes!!!!!

We were told not to worry about night time hypos, L would wake up!!!  So I haven't tested at night/ after I have put her to bed, and I am a light sleeper when it comes to hearing the children at night.  She has been waking up with very low readings in the morning, and yesterday we saw the doctor who said this was very normal, and to reduce the night time (glargine) by one unit, to see if this makes a difference.  We were told she is in the 'honeymoon period'

I don't think I will ever sleep again.......


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## Adrienne (Sep 18, 2009)

michelle g said:


> Cripes!!!!!
> 
> We were told not to worry about night time hypos, L would wake up!!!  So I haven't tested at night/ after I have put her to bed, and I am a light sleeper when it comes to hearing the children at night.  She has been waking up with very low readings in the morning, and yesterday we saw the doctor who said this was very normal, and to reduce the night time (glargine) by one unit, to see if this makes a difference.  We were told she is in the 'honeymoon period'
> 
> I don't think I will ever sleep again.......



Hi Michelle

The worrying thing here is that you were told not to worry.   Consultants and medical pros who say this need shooting.    There is evidence in studies that the majority of children do not wake up when hypo.

If L is in honeymoon then there should be less hypos but as soon as you start seeing the swings and the high and lows then honeymoon is over.   I am in preferenc to giving Lantus in the morning for children.    It works better for the first 12 hours and doesn't ever really last the full 24, normally between 18 and 22.    

If you do decide to test overnight then they say the best time is between 2.30 am and 3.30 am, this is when the body tends to go lower.   If you keep getting up you will be knackered so make it at the right time and make it count.  I was told this a conference in the summer and it makes sense.

If a child is waking up too low then it could be they are on the way up from a hypo.


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## Janet (Oct 2, 2009)

I have been reading with interest of different experiences with Hypo's.

My son (so far) hasn't really experienced any.  We are in Portugal and Have been told by our specialist that if he is 'low' at 10-11pm.  to give cerial & milk.  If it was low at this time then to wake at 3am and check again.  If still low give milk and a biscuit or a slice of bread as carbs are needed.  I have never had to give him anything at 3am (dont do a blood check every night) but as a light sleeper I most nights go and give him a little dig to check he is oK.  Our son has been diagnosed since June.  We have been told that he is going through a honeymoon period - which could last up to 1 yr. But often wondered how we would know when he has come out of this.  Thank you Adrienne!!  You have just prepared me for this.  I thought he would settle into regular readings.  But now I know he will have swings.!!


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## Adrienne (Oct 2, 2009)

Janet said:


> I have been reading with interest of different experiences with Hypo's.
> 
> My son (so far) hasn't really experienced any.  We are in Portugal and Have been told by our specialist that if he is 'low' at 10-11pm.  to give cerial & milk.  If it was low at this time then to wake at 3am and check again.  If still low give milk and a biscuit or a slice of bread as carbs are needed.  I have never had to give him anything at 3am (dont do a blood check every night) but as a light sleeper I most nights go and give him a little dig to check he is oK.  Our son has been diagnosed since June.  We have been told that he is going through a honeymoon period - which could last up to 1 yr. But often wondered how we would know when he has come out of this.  Thank you Adrienne!!  You have just prepared me for this.  I thought he would settle into regular readings.  But now I know he will have swings.!!




Hi Janet

Nice to 'meet' you.

I think the thing is with newly diagnosed families is that some medical teams don't want to frighten the families so miss vital bits of info out.   This is all well and good but doesn't prepare the families as to reality and life with diabetes.   Even if people say diabetes doesn't change your life, it does, it very much changes a mother's life as our emotions go into overdrive and we are constantly worried.   We all prod and poke our kids in the night to see if they are still with us.  How worrying is that?  We never thought we would have to do that.

Now what does your consultant mean by 'low'.   If your son is under 4.0 mmol that is considered hypo and quick acting carbs are needed.  Then depending on what regime your son is on, some long acting carbs may be required once he is back up over 4.0.    However if he just needs a boost at 10 pm and low is about 5.0 ish then long acting carbs are ok ie milk and toast or biscuits etc.  However you need to be careful how much you give him so you don't send him too high !!!!   How confusing is all that.

If in honeymoon you should be seeing some lovely numbers for a while.   As soon as you start seeing the erratic numbers then you know honeymoon is coming to an end.   Take care


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## Janet (Oct 2, 2009)

Hi Adrienne  

With ref to readings.  Our readings over here are different.

The 'low' our specialist referred to was below 70 (pt) equals to 4mmol (uk)

She gave me a chart of comparisons ie : 90 = 5mmol  140 = 7.8mmol  180 = 10mmol.  (just a few examples).

But it was interesting what you said about carbs taking him too high.  I will defo be aware of this in the future.

At the moment we are aiming for between 100 (5.5mmol) & 180 (10mmol) but this will eventually come down to between 80 (4.4mmol) & 140 (7.8mmol).

He is following a healthy eating plan that the dietician gave us.  But still has  highs & lows, when we are least expecting them.  We still have yet to have a few days on the trot of 'level' readings.   (I will get the flags out!!!).


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## Adrienne (Oct 2, 2009)

Janet said:


> Hi Adrienne
> 
> With ref to readings.  Our readings over here are different.
> 
> ...



Hi Janet

I wondered about the numbers.   I have a convertion chart at my fingertips as I am always online with the USA and other places and they use the same as you.      The general rule of thumb here is between 4 and 10 maximum for kids.   On a pump, as we are, it is easier (allegedly to get it 4 to 7 with much tighter control).    We are still 4 to 10 although I now correct anything over 9.0.

Any questions just ask away and I'll see if I can help, if I can't I know another 300 families that can !

Have a look at www.childrenwithdiabetesuk.org  loads of info.  It is written by parents for parents.   The email list on the front is a very busy list and is just for families with type 1 children.  Feel free to join.


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