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How do you treat a low???

Discussion in 'Parents of Children with Type 1' started by bbirdnuts@aol.com, Jan 7, 2010.

  1. bbirdnuts@aol.com

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    Please explain to me the proper amount of sugar/foods to use to treat a low. I don't believe I am treating lows properly based on a post from this morning.
     
  2. Christopher

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    I try and use the rule of 15. 15 carbs of fast acting glucose, wait 15 minutes and test. If still low, 15 more carbs of fast acting glucose and test in 15 minutes. I prefer glucose tabs to treat lows. I know exactly how much she is getting and they act fast. You will get other responses from other people who use other things. This is just the way I do it. Good luck....:cwds:
     
  3. tiffanie1717

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    In the beginning with Kylie I did not use 15 grams because that would sky rocket her bg. There was a chart floating around here (I think it was in a powerpoint presentation on cwd's main page) that had grams to use by weight. At first she was so small I used 6-7. Now, after 1 3/4 years we use the 15 rule. YDMV. :)
     
  4. momma_fish2007

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    Yep, I agree with Christopher. Remember too that chances are very good that there will be a rebound high once all the carbs start really working on Carolina.

    Our favorite things to treat lows are milk (most preferred for us as long as it's not whole milk) because it brings sugar up and seems to keep it up. Sometimes though it's hard to coax my toddler with milk so we bring out the capri sun juice boxes (the 25% less sugar ones are exactly 16g) and the gummy fruit snacks in whatever their favorite characters are.

    Remember the biggest thing is to keep the things high sugar, low fat. Use things like sweet tarts, glucose tabs, juice, etc. We thought we were clever once using chocolate chips but for when they're really low you don't want something with that high of a fat content...
     
  5. mapoe4

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    For John I give him a juice box that is 15 carbs if he is below 60. and wait 15 min then retest this usually works for him. He really hasn't had a low that he has needed anymore except once. If he is at 60 usually a pack of smarties will bring him up. This also depends on how long it is until his next meal. If say it is only 30min to an hour for the meal then smarties will bring him up into the low 100's. Juice brings him up into the higher 100's
     
  6. Brandi's mom

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    We use the same rule. Thats what we were taught in the hospital.

    I like to use the glucose tabs too. Our CDE said they were really nasty and tasted gross and reminded her of Tums, but one day I saw some green apple and raspberry flavored ones and thought they might be good, so I got one of each tube and turns out Brandi likes them ALOT. She says they taste like sweet tarts to her.

    We also use juicey juice grape flavor juice boxes and fruit by the foot.
     
  7. fdlafon

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    Jordan refuses glucotabs, so we use 2-4 starbursts (depending on the low #)
    4 Starbusrts are approximately 16 carbs, and those little individual packets hold up well inside bags, pockets, etc.
     
  8. Sarah Maddie's Mom

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    I'm not sure I understand the, "rebound high" you are mentioning here, and I think it might be a bit confusing to the OP. Can you elaborate on what you mean by "rebound"?
     
  9. momma_fish2007

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    For us anyhow, Julian almost always goes high after a low (from the body's defense system of the liver dumping glucose to self-treat the low) That glucose added to the carbs used to treat the low end up putting us up in the 300s and 400s.

    Was I off in saying this? I'm still kinda learning too so any advice from you veterans will be appreciated :)
     
  10. Logansmom

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    For us it depends on how low. If it's an exercise low, we tend to treat more aggressively as they last longer for him. So he'd get a juicebox. Otherwise, if he's just on the lower end of our comfort zone he gets half a honey maid graham cracker (6 carbs).
     
  11. Amy C.

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    Not every child rebounds after a low. When my son rebounds, it is hours later.

    Our lows are treated with juice (15-30 grams) and glucose tabs (15 grams).
     
  12. Sarah Maddie's Mom

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    I think that a true "rebound" only occurs with a severe low. What you may be seeing is just a normal rise from the carbs used to treat a moderate low which probably means that Julian's carb sensitivity is lower than you think. It's really, really common to over treat a low, we all have done it, but it's a drag because you end up chasing post low highs.

    There have been many threads by the mathematically gifted (aka, folks other than me:p) discussing this issue, as here http://forums.childrenwithdiabetes.com/showthread.php?t=24684&highlight=correction+factor
     
  13. saxmaniac

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    First, we always use glucose (tabs or gel) for anything lower than 70. I learned the hard way.

    1 tab for a mild low (around 60-70)
    2 tabs for stronger low (50-60)
    3 tabs for bad one (< 50)

    Recheck in 20 minutes, as 15 minutes is not enough for Alex. Also add one extra tab if a previous low correction failed.

    Alex's BCR is about 8 and target 120, and this doesn't perfectly line up with that intentionally. The lower he is, the more glucose we add, to account for any drops and a larger safety buffer.
     
  14. Nancy in VA

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    We use juice, fruit snacks, or glucose tabs.

    We use the pump to calculate how many carbs we need, based on the IOB and the negative correction needed to get her back to target, but we can usually tell just by the number and our "gut"

    Below 70 with IOB - 15g
    Below 70 with no IOB - 7g - 10g
    Below 60 with IOB - 20g
    Below 60 with no IOB - 10g - 15g

    We also use the trending on the CGMS to tell us whether she's dropping or just creeping down and if she's dropping fast, we give more.

    Always give fast acting glucose with little/ no fat - fat slows down the absorption of the carbs.

    For us, 15 minutes is not enough to know that she is going up. 20-30 minutes is the minimum to really see her going up. I learned this through a lot of giving carbs, checking at 15 mins and giving more, only to find her going extremely high because we overtreated. On the CGMS, it can take up to 45mins to start seeing her coming up, but as long as she doesn't keep dropping on the CGMS, I'm ok with waiting that long.
     
  15. Flutterby

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    We can't go by the 15/15 rule because 15 carbs are way to much for Kaylee.. it took time to figure this out, not all kids are the same.. usually one large glucose tab or 4 small (1carb each) will work. We do, on occassion, get some nasty stubborn lows that will take a full juice box, or more, yesterday it took 2 juice boxes.. we tend to test at the 10minute mark for really low (anything below 55, or if she's complaining she's still feeling low, or isn't looking right).. these are all things that you will figure out in time..

    If we treat with 15 carbs automatically, we will get a high after that will need to be corrected with insulin.. so we get this rocky mountain blood sugar action going which sets up for an angry Kaylee.
     
  16. shekov

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    If I followed the 15 carb rule that we were taught dd would be sky high!

    She's too little so doesn't need many carbs to bring her bg up.

    1 tablet for mild lows - 75ish
    2 tablets for 60s

    retest after 15 min and follow up with a carb and protein snack.
     
  17. willie's mom

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    We also use the 15 carb 15 minute rule but if it is going to be an hour or longer until Will eats we give him 2 peanut butter crackers or just a Jif to go. He needs the protein to hold him until lunch.
     
  18. danismom79

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    In general, I treat lows with glucose tabs. I know that 1g of carb raises my daughter's BG by about 7 points. Our glucose tabs have 4g carbs each, so 1 tab would raise her by about 28 points. This is helpful to know so that I don't overtreat.

    But there are different kinds of lows, and I treat them all differently.

    - A sudden drop gets glucose tabs.
    - If there's bolus insulin still working, she gets tabs, plus however many carbs needed to cover the insulin on board.
    - Excercise-induced lows get tabs, and a snack (amt of carbs depends on how low she is and how hard she was working).
    - A gradual decline due to not eating for a period of time gets a snack and a little insulin deducted from the bolus.
     
  19. AlisonKS

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    we usually give 12 carbs, seems to do the trick. We were taught originally to give 15 carbs when our son was dx at 20 months old-it took us awhile to figure out why he was so damn high after that-I think he was only 20 pounds around that time, little guy.
     
  20. hawkeyegirl

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    One carb raises Jack's BG about 8 points, give or take. It's important to figure out this number for your daughter. Sometime when it's been a while after a meal, and when her blood sugar is between 80-130, give her something that you know has 4-6 carbs. Skittles are really good for this purpose, because they act super fast. Test her at 15 minutes, a half hour and 45 minutes. This should give you a pretty good idea how much one carb raises her BG.

    You can see how the 15/15 rule doesn't work for us. 15 carbs would raise Jack's blood sugar about 120 points. And although we usually check in 15 minutes, the full impact of the carbs will not be seen that quickly for us.
     

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