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Thread: Low melt downs and tantrums with a 2 y..o

  1. #1
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    Default Low melt downs and tantrums with a 2 y..o

    My 2 y.o. T1 is a "baby from hell", as someone described him once after watching him for a day. On top of being an extremely picky eater, he is the classic "terrible 2s" times10. I have other children and never have encountered such extreme tantrums and melt downs. He hates juice, milk and any other drink or sweets (no ice cream, candy, or sugar of any kind) and only drinks water. When he is low (anything below 4) he gets super cranky and will push, bite and kick me like there is no tomorrow. Treating lows is almost impossible, unless I have his dad holding him in a headlock and I would spray some dex gel with a syringe into his mouth and hold his jaws together so he wouldn't spit it out. So when I am alone with him and we have a low episode I am terrified! I am really at the end of my wits and have been using mini shots of glucagon on a regular basis because its the only way. I guess my question is maybe some of you with small t1 kids know some tricks I can try. Please help!

  2. #2

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    Have you considered a CGM? If you get a CGM, then maybe you can head off some of the lows by catching them when he's still higher and you can treat with food he'll eat instead of the more urgent lows. Sorry I don't have a lot of tips because I'm fortunate that my T1 will eat basically anything, which is helpful since she's also celiac!
    ~Nancy
    Mother to:
    Samantha - 17
    Michael - 14
    Emma - 9 (2/16/05 dx 3/07, dx Celiac 1/10) - Pumping with a Pink Animas Ping! as of 9/07, with t:slim as of 8/14!

    CGMSing as of 3/26/09 with Navigator, 9/14/12 with Dex 7, 12/5/12 with dex G4

  3. #3
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    Thank you, Nancy! We actually have been using Dex since he was 11 months old. And it def. helps to avoid a lot of lows, but he still has at least two lows per week when I am simply not able to treat it before it becomes a true low. It usually happens when I am by myself with him and simply can't get him to eat anything. And its just getting worse. A low in the upper 20s is not uncommon for us anymore. It s so scary!

  4. #4
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    Also, I used to prebolus him for meals. I can't do it anymore because I don't know how much he will eat or IF he will eat at all. As a result we have a huge spike in the 300-400s about an hour after meals, especially breakfast. His a1c went up from 6.2 to 7.6 in just 6 months. We are pumping with Omnipod. Our endo is very sympathetic and helpful and always tell me it will get better as he grows. He gave me an Rx for 20 glucagons with repeats, but somehow it feels wrong to use it so much. When? When is it going to get better?

  5. #5

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    Well, I'm sitting on the sidelines (not having had a 2 year old with D) but from the outside I'm thinking maybe you would want to consider loosening your "control" just a bit for a period of months to give him a chance to grow out of the phase and to lessen your stress within the family? Maybe his target bg could come up by 10 or 20 pts just for a while and with your endo's assistance so you could give him a break from the lows and the struggle?

    Like I said, just a thought from the outside.

    Good luck. It sounds really hard.
    Sarah
    Mom to DD now 16, dx @4
    Cozmo pumper @6
    Minimed pumper @13
    G4 @ 15


    "Happy Birthday, Dr. Banting! Now... let's eat cake! Because, we CAN!" - MCS

  6. #6
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    Thank you! That's what our endo suggests too - to loosen control for a little while. But its hard to accept an a1c of 7.6 after 6.2 I guess. I am predicting the next one to be well in the 8s. It is a huge stress for me and def. my other children. What a mess!

  7. #7
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    I will suggest the same thing, aim for a higher target and if need be give more smaller corrections rather than a larger correction that can go below your target and cause a low.


    Is there any rhymn or reason to the lows? do they happen more often after meals boluses or just after meals with corrections? out of the blue?

    Maybe he needs to have a higher basal to makeup for the no prebolusing and less insulin for meal coverge? You can manipulate insulin to work for you rather than against you especially when dealing with a toddler that is picky and a target that is very low.
    McKenna DX 1/3/06 @ 13 months^9.5 YRS
    Pumping @ 18 months & Dexcoming @ 4.5 yrs
    PINGing - leopard Tethered with Lantus
    Madison DX 3/17/14 @ 5yrs thru Trial Net^6 YRS
    Started with Dexcom and now Pinging - gummybears

    impaired glucose at 2hr mark
    8/12 BG 166^4/13 BG 205^6/13 BG 143^3/14 BG 216
    faith trust and pixie dust

  8. #8

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    Quote Originally Posted by natallia View Post
    Thank you! That's what our endo suggests too - to loosen control for a little while. But its hard to accept an a1c of 7.6 after 6.2 I guess. I am predicting the next one to be well in the 8s. It is a huge stress for me and def. my other children. What a mess!
    Try not to let the A1c loom so large. Since my dd was dxd we've probably had 30 A1cs - some great, some down right ugly but the A1c that broke my heart 9 A1cs ago is a distant memory - the now matters and that's the now of the numbers and the now of the child's overall wellbeing.
    Sarah
    Mom to DD now 16, dx @4
    Cozmo pumper @6
    Minimed pumper @13
    G4 @ 15


    "Happy Birthday, Dr. Banting! Now... let's eat cake! Because, we CAN!" - MCS

  9. #9

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    I am sorry you are going through this. I'd say decrease the basal rates. Adjust his settings so he runs a little higher. Give the family and his liver a break and especially the little guy. An a1c is not our grade a happy healthy child is what we should strive for.

    Take a breather relax it will work out he will want to eat again.
    Have you tried any combo bolus methods.

  10. Default

    I don't really have too much I can personally add unfortunately. My daughter was dxd at 17 months but she took it really well, she's always been a good listener and all around a good kid. I got lucky with her. I'm sure my son will give me hell when he turns two though.

    His tantrums could be that bad because he's feeling the changes in his BGs but can't voice how he feels, so he lashes out. I have heard of older t1s that get angry when low and just can't control it.

    About the issue with prebolusing and the spikes. When we were using humalog, we'd see those spikes all the time. It wasn't until I found out about Apidra on this site did I decide to try it out to see if it would make a difference. While my daughter's been on apidra, the spikes have been minimal (compared to before). I also utilize prebolusing a lot more now than I did before, but that's because she's 5 and a good eater so I know she will eat everything I give her.

    I prebolused her this morning (always before breakfast!!!) and at the height of the carbs starting to digest, her BG was 156. She started at 128. Apidra has been a very good change for us so far. I saw high highs on Saturday but that was because she had a birthday party with pizza and cupcakes yay

    For his age, an a1c of 7.6 is fine, lows in the 20's though, that frequently, I wouldn't be ok with. If he was diagnosed not too long ago, that a1c of 6.2 could've been a honeymoon a1c, and those really aren't accurate as "full blown" diabetes hadn't really hit yet.

    I would try to find some stuff he likes, I feel like there has to be some sugar he likes.
    Kristen

    Mom to
    DD 5: 10/11/2008- diagnosed 3/31/09 at 1.5 years.
    3/31/09- 01/2012- Humalog and NPH
    01/2012- 04/18/2013- Humalog and Lantus
    04/18/2013- Pumping with a Pink Animas Ping
    09/13- back to MDI with Apidra and Lantus
    Currently pumping with Novolog

    DS born July 29, 2013

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