What is your child's normal bg range?

[akrickard]

Our endo says a healthy range for a five year old is 70 - 180. She's been between 63 and 400 since returning home (diagnosed 4/2/06), but normally ranges between 70 and 290. Should I be worried when she's over 180 for several checks in a row? She's never that high for more than 12 hours.

[bkfkmc]

My son is five and we are five months since diagnosis. It is not uncommon for him to have occasional days that he runs above target. If we are traveling or a major change in routine, then he can have unusual highs (other that sick days). However, if this happens for several days or I see a pattern, then I call numbers in to the endo. to see if we need to make changes to insulin. Are you on a sliding scale to administer extra insulin at meal time if the pre-meal reading is above a certain number? Usually, this will take care of it for Braden. However, there are days sometimes that nothing makes sense!

[lisamomtotwins]

I would be concerned and try to have it under the 200 range. It is still the beginning so it is going to be roller coaster dont beat yourself up over it. My husband is type 1 and is in great control but now my daughter just diagnosed a week and 1/2 ago is kind of out of control. Today she was in the 400's a few readings, it is so hard to know what to do and she is not eating very much at all. We applied for the pump yestorday and that is going to help tremendously! But it will take a month before we get it. Good luck.

[lisamomtotwins]

Also do you check for ketones? That is important. If you have more than 2 high readings in a row you should check for keytones. How often do you test?

[akrickard]

Yes, we give her a 1/2 unit of insulin if she is over 250 at dinner. We try to have her over 200 at bed, though, because she drops so low overnight. Even at over 200, she sometimes tests at under 70 in the middle of the night.

We test her a minimum of five times a day and test for ketones anytime she is over 300.

[selketine]

You are really early after diagnosis so expect a few bumps on the road!

William is 4 (dx'd at 26 months) and his range is between 100-250 with a target of 150. His target and ranges are higher because of his age. I'm sure that his pedi endo is going to eventually lower our range and target as he gets older.

180 doesn't sound terrible to me - but if you keep running 180 and above consistently then perhaps some adjustment to the insulin doses are in order - you can ask the dr. about that. I have been told that lows at a young age are worse for the child than highs and that it is better to run a wee bit higher consistently than have constant ups and downs. By that I mean constant big swings in bgl readings.

Before the pump when we were on NPH and humalog William's numbers were often in the 300's - 400's between breakfast and lunch (he was also 2 yrs old though!). Then with NPH we'd get an extremely wicked sudden drop. He sometimes would go from 400 to 60 in a half hour. NPH is a difficult insulin - it has advantages but we found him to be much more stable on lantus once he started needing insulin 24 hours a day. William never ran ketones right after diagnosis unless he was sick. It is always good to check to make sure of course - especially if you have consistently high numbers unexpectedly.

If she is going low at night I'd certainly contact your dr. She also may still be in the honeymoon period which can give you unexpected numbers.

[lisamomtotwins]

How come it is dropping so low at night? What tye of insulin is she on? Perhaps she needs a lower dose at night? Lows are so scarry at night. Do you chart all her BS? It sounds liek you are doing a great job. Have you thought about the pump?

[Ben'sMommy]

Our endo has Bens normal BG between 5 and 10. (90 and 100). Ben is 2 years old.
Although having blood sugars in the normal range is preferable, it is not always going to happen and there are millions of reasons why.
Some you know and some you will learn as time goes by.
One thing that affects Ben more than anything else is stress. Long journeys, missing naptime, teething, tantrums :eek: etc all cause his BG's to go nuts.

You are still adjusting and it will take time before you reach a level of normality. Don't be too obsessed with having them in perfect range. It will make you crazy.

As long as there are no ketones a high BG is not dangerous. Obviously it's not good but a low is much worse.

Take one day at a time and be kind to yourself. Don't feel guilty or responsible because it is a normal transition and will eventually even out.

[akrickard]

She drops that low at night on her own. She is currently only receiving one shot in the morning. She gets 1/2 unit of NovoLog and 6 of NPH. It is the only shot she gets all day long and I chart everything.

We will consider a pump when she needs more than the one shot or when she expresses interest. With camp and the support group we'll be attending next month, Ginny will be exposed to many kids with pumps, and I'm hoping it piques her interest.

What exactly happens during lows that is so dangerous? I mean, I know they can eventually have seizures and go into comas, but what happens when a child is running in the 60's?

[lisamomtotwins]

My endo said it is not good for brain develpment for a child to go below 80. And yes they can die if there sugar is low and they are sleeping and go into a seizure, it has happend to my husband alot! ANd it is very scarry, it is not anything i ever want to experience with my daughter! EVER!!!!!!! Perhaps is she is only on 1 shot she should be on Lantus. It sounds like that might be better for her? Did the dr ever speak to you about Lantus insulin? That just seems so strange to me that she is only needing 1 shot a day, i mean i am not an expert or anything but even those numbers only 1/2 unit of novolog and 6 of NPH seems like an odd ratio. What are her readings at lunch and dinner and after lunch and dinner? Right now my daughter gets 2 untils of Novalog and 2 units of NPH in the AM then at night like .8 of Novolog and .5 of NPH. and she is 17 months old. I know everyone is different and Hailey is still also in the honeymoon period. So things are going to change alot over time!

[zimbie45]

i would worrie about a range of 180.. for us thats still a normal....of course you want to listen to you endo, But charlzie is 5 and her normal ranges are 100 to 200... her bs goals for correction for insulin are bs-150/100 all day but dinner and bs-180/100 for dinner.... we consider 80-100 on the low-high ( if that makes since) side adn any thing below 70 just plain low.....What we where told is its better to keep a young child in this range for a few reasons.. 1. they are so young and so active.. they need the extra,.. adn 2. developmental puroses..

hope this helps

[EmmasMom]

We have a target of 120-200, but that's in an ideal world :D . She usually runs 90-250 on good days and still goes over 350 a few times a week.
Age plays a huge role in BG targets. Our endos don't want her below 100 ever and advise me to keep her around 200 most of the time.
Severe lows are extra risky in the under 5 age group, (and even worse under 3 yrs), because of rapid brain development, and can actually cause learning disabilities and permanent brain damage without seizures or loss of consciousness. The 60's however are not really dangerous, just uncomfortable and can cloud your thinking.

[EmmasMom]

[QUOTE=lisamomtotwins]And yes they can die if there sugar is low and they are sleeping and go into a seizure, it has happened to my husband alot! ANd it is very scarry, it is not anything i ever want to experience with my daughter! EVER!!!!!!! QUOTE]

Why does your husband keep his sugar so low at night? If my husband was having seizures I would insist that he make some adjustments to his basals. An A1C of 5 is only good if your quality of life is not adversely affected by trying to achieve it. That's very scary for you, and long term daughter it could affect your daughter!

[selketine]

For the OP's child to be on 1 shot of novolog and NPH in the morning isn't that unusual. William was on a similar schedule after he was first diagnosed. He also sometimes only needed fast acting in the morning for breakfast and the NPH covered lunch. At dinner he didn't always need insulin and he did not need any insulin at all at night for several months.

Lantus is NOT a good idea because it is a 24 hour insulin and if she is going too low at night already with only the leftover NPH working on her then the lantus would definitely cause serious lows at this point.

It is useful to know what insulins she is on but don't try to compare your child's insulin doses or ratios to anyone else - except for entertainment purposes! Kids are very different at diagnosis and what works for one is a disaster for another! I know folks often suggested to me that William's carb ratio should be 1:15 and it was much higher at the time (like 1:45 or 1:60 at diagnosis). The 1:15 thing is a common ratio but certainly not for everyone ;)

We would sometimes give William a bit of yogurt (drink yogurt usually) at bedtime and mix a bit of corn starch in there. You can find some corn starch recipes on the internet that are used for diabetics. The corn starch supposedly releases its carbs very slowly and keeps them up for a longer time than other things. It worked for us at the time.

Here are some links on using cornstarch:
http://www.childrenwithdiabetes.com/dteam/2000-06/d_0d_4w9.htm
http://www.childrenwithdiabetes.com/dteam/1996-11/d_0d_1bv.htm

I still think talking to the dr. is useful but you might ask about a slight nightime snack. Even something like a couple of crackers and cheese could help.

I don't think running in the 60's is terribly dangerous for most kids. I have read of children going unconscious and being 60 or so but that isn't typical. William has been as low as 24 and acted normally. He has also been 64 or so and later we think he had a "rebound" reaction. I do feel it is safer for him to run higher than lower.

Hang in there!

[lisamomtotwins]

[QUOTE=lisamomtotwins]And yes they can die if there sugar is low and they are sleeping and go into a seizure, it has happened to my husband alot! ANd it is very scarry, it is not anything i ever want to experience with my daughter! EVER!!!!!!! QUOTE]

Why does your husband keep his sugar so low at night? If my husband was having seizures I would insist that he make some adjustments to his basals. An A1C of 5 is only good if your quality of life is not adversely affected by trying to achieve it. That's very scary for you, and long term daughter it could affect your daughter!

He doesnt keep his blood sugars low at night, for some reason he is very unpredicatable with his bs readings, he could be 140 at night have a snack and I wake up 3 hrs later to him seizuring. We dont understand why. It is not a constant thing but def happens like every few months. Just out of no were. Even yestorday we ate at my moms he was fine i think he gave to much insulin and like 2hrs later he was 40! He has been diabetic for a long time and doesnt feel his lows so he has no idea when he is going low! It is so frustrating and I am trying to get in his head he should be a little higher esp now because of my daughter, he has to set a good example! So we are trying.

[EmmasMom]

That's so scary!
I recently read an article that said you should let your sugar run high, (over 200) for a week and then gradually bring the numbers back down. It can help your body renew the symptoms of hypoglycemia. Maybe he could try it??? (with his doctors guidance of course)

My father lived for years with severe hypoglycemia unawareness and it was awful for my family. There were days he just never cam home from work because he was parked on the side of the road somewhere not knowing who he was, he was in several accidents and had seizures from time to time.
I'm sure it's a big part of the reason I'm so hard on my husband about his control, and why I'm over-cautious about Emma's management.

I hope you find something that will help!

[lisamomtotwins]

Thank you Amy, I am going to have him speak to the dr about that! He actually goes tomorrow for check up so i will make him ask him.

[melissabeth]

Severe lows are extra risky in the under 5 age group, (and even worse under 3 yrs), because of rapid brain development, and can actually cause learning disabilities and permanent brain damage without seizures or loss of consciousness. The 60's however are not really dangerous, just uncomfortable and can cloud your thinking.

Okay, you just freaked me out a little bit. Colby (19 months old, dx'd at 10 months) has hypos at least once or twice a week (usually between 50-60, but sometimes as low as 35). Do you remember where you read about how this affects their brain development? We're always asking our endo about this, but he says not to worry since we're doing the best we can.

[BrendaK]

Our endo said the same thing about lows -- that too many severe lows can cause brain damage in very young children. The brain needs glucose to grow and develop. If it's deprived of glucose too much, damage can happen. I would be concerned if your endo isn't trying to prevent those lows in a baby.

Our endo didn't want Carson's blood sugars below 100 as a baby/toddler because we didn't want to risk those lows. He would always say that you can you can deal with the complications from high blood sugar and sometimes reverse those complications, but you can't reverse brain damage. I think his target as a baby was between 100 and 200. Now that he's older we try and keep it in the lower 100's -- but it still goes up and down a ton.

[lisamomtotwins]

Same with us, our endo said the same thing. 100-200 , and try very hard to avoid the lows. Shoot for the higher numbers right now. Hailey went down to 49 twice so far, it scares the he!! out of me! ANd we are trying to prevent this as much as possible! Good luck.

[EmmasMom]

Okay, you just freaked me out a little bit. Colby (19 months old, dx'd at 10 months) has hypos at least once or twice a week (usually between 50-60, but sometimes as low as 35). Do you remember where you read about how this affects their brain development? We're always asking our endo about this, but he says not to worry since we're doing the best we can.

I was told (and read) from the beginning to be extra cautious about lows since she was a baby, (the doctors advised us to try to stay above 100 at all times.) But again, for brain damage we are talking bout severe lows typically < 40. If you're having lows in the 30's very often, you may need to change the insulin type and/or dosing. Is he on NPH? We had lot's of lows on NPH and it was impossible to fix it until we changed to the pump.

The best research I have found is from a study at The University of Pittsburg School of Medicine, it is a long paper but I will quote a section that I highlighted.

"Researchers have now identified at least one subgroup that is particularly vulnerable: children with an early onset of diabetes. Studies conducted over the past 20 yrs have repeatedly demonstrated that children and adolescents diagnosed before age 5 or 6 yrs of age have a greatly elevated risk of experiencing severe hypoglycemia and of abnormalities on EEGs, (brain scan), and by poor performance on a variety of cognitive tasks, including measures of learning and memory."
"It is now widely believed that the first 5 yrs of life constitute an especially critical period for brain development, and the occurrence of either hypoglycemia-associated neuroglycompenia and/or chronic hyperglycemia during that critical period may induce structural and functional brain abnormalities that interfere with normal cognitive function."

Lows are going to happen, and I agree that we just "do the best we can". But, I have found many times since Emma's diagnosis that some doctors don't really know what "the best" can be! Emma was the first baby to be put on Lantus, and to get a pump in our endo's office. They thought NPH was the best thing, now they know better!! :D

[melissabeth]

Thanks for the information. Although I have to say that the more I read about diabetes the worse I feel...My husband won't read boards like this for exactly that reason, but I feel compelled to learn as much as possible.

Colby has been on the pump for a few months (he was on Humalog/NPH at the beginning and it was a total nightmare, bs would go from 400 to 40 and back almost daily, and sometimes it took us 30 minutes to get his bs up after a hypo because the NPH kept working). Things have greatly improved, but we still have to change his dosages every 2 weeks or so because what works well one day will give him hypoglucemias and/or really high readings another day, even though we measure his carbs for every meal down to the gram and he's been eating the same amounts since he was diagnosed at 10 months. It's so frustrating! A few weeks ago he was a little low before lunch (55) so we gave him some jam, but when we tested him 10 minutes later he was at 36! I feel like nothing we do works well for longer than a week or so, and we already check his blood sugar literally at least 9-10 times a day, which probably isn't good for his little fingers either...Sorry, this is turning into a little bit of a rant! Anyhow, thanks again for sharing the study and the information.
Melissa