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How to treat a low in the middle of the night?

Discussion in 'Parents of Children with Type 1' started by Aeagle, Jul 25, 2011.

  1. Aeagle

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    How to treat a low in the middle of the night? Our princess Abigail had lows all night long. We had to get up almost ever hour or two to check on her. Her blood sugar dropped every hour or so. It was hard to make her eat and drink when she does not want to stay awake and eat. What do u give your kids at night? We have had some lows, but not to many in the middle of the night before. I am scared to even go to sleep! I am scared that she is not going to wake up :( How do I get her to eat enough so it want drop again. We gave her gummy bears and some juice but she just drinks enough to get it up and then it drops again. I would love for some ideas or advice thanks
     
  2. Mom264

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    Hi. Sorry you are going through this. Please let use know what type of regimen your daughter is on.

    Is she on shots?
    What type of insulin (Or Insulins)does she get and how much?
    At what times?
    What insulin ratio?
    Does she get a bedtime snack?
    This will help people here respond to you in a helpful way.
     
  3. Sarah Maddie's Mom

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    That's a sign to lower her basal dose. You shouldn't have to be feeling the insulin on a regular basis.

    That said, even with the correct dose we see the occasional low at night. If it's hours till morning and I have reason to believe that the low is caused by daytime activity, and as such, may be prolonged, I treat with a bit of chocolate milk. If it's within 2 hours of wake-up time I use juice. Generally, they just get used to it and most D kids can suck on a straw while still pretty much fast asleep.

    And fwiw, they are all princes and princesses ;)
     
  4. kjmaf

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    We use juice boxes in the middle of the night - we can stick the straw in Sarah's mouth and she drinks without ever really waking up. You can can try something with protein (I think I have that right) such as chocolate milk to help keep her bg up longer. I'm sure someone else will chime in with the specifics - we generally have not had problems with her bg staying up yet once treated.

    On a pump you can set a decrease basal to help with this, but obviously that is not an option if you are on shots.
     
  5. virgo39

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    We treat lows with glucose and then follow up with what we use to treat DD when she is not low, but below her bedtime target -- chocolate milk-we use the Nestle's 100-calorie stuff that is sweetened with Splenda. One carb raises her BG by about 8-10 points, so just a small amount -- 1/4 cup -- works for us -- perhaps because it also includes some protein and fat with the carbs. We try to have her sip some water after to rinse her teeth.
     
  6. Aeagle

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    Abigail is on a 4 units of Lantus and a sliding scale of humalog it is 101-200 1 1/2, 201-300 2,301-400 2 1/2, 401-500 3, > 500 give 3 1/2 at breakfast, lunch and supper. We are supposed to give her a bed time unit of humalog if it is greater then 200 or more but we dont like to give it to her b/c it drops even with a snack. We give her a snack almost every night.


    and fwiw yes they all are prince, princess :cool:
     
  7. Jake's mom in NC

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    I use milk or those Danimal yogurt drinks and then I follow with a peanut butter sandwich. He usually will only take a few bites, but I think the protein sustains him better through the rest of the night. Good luck!
     
  8. Sarah Maddie's Mom

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    And she's newly dxd and only 2 1/2? That seems like a lot of insulin to me. Are you logging her numbers and sharing them with the endo?
     
  9. Lenoremm

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    I agree about adding some protein in. We use crackers with peanut butter and a gulp of milk to get it down. The protein gives some staying power. If this is an ongoing problem I would certainly adjust the basal.
     
  10. Mom264

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    Are you giving the Lantus at 9 pm (or bedtime)?

    This is what our endo had us do when my dd was small and on MDI with Lantus. She dropped overnight too.

    There can be a peak in action 4-5 hours after the Lantus shot--espesically with small children and seniors.

    You might want to ask your doc about that and see what he/she advises for your little one.
     
  11. Aeagle

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    yes we are writting them down and faxing them ever week. Her blood sugars are high during the day usually around from 250-400. At night is when they are getting low. We have not had this problem very long. She was doing really good with her blood sugars staying around 100-260 or so about a week or two ago. She has been on antibotics for over a mth due to a bacteria in her urine. Idk if this is making it go all crazy or what? We are going for more test this week for the bacteria. They are going to do a vcug test on her to make sure her kidneys are doing good. We just cant get her blood sugars to stay up at night this week. Thanks Ladies for all the advice :)
     
  12. Aeagle

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    thank you :)
     
  13. Aeagle

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    thanks I will try this :)
     
  14. Lisa P.

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    My kid at 2 years old ran less than 2 units of Lantus, 4 does seem high even for a kid with an infection, you might want to take one day and test around the clock to get a good picture of exactly what is happening.

    We see a very, very strong Lantus peak at 5 hours in, we cannot give her Lantus at night or we'd have to feed her probably 30 carbs or more at 2 a.m. every night. We give Lantus in the morning!

    Selah has had one stubborn UTI, they wanted to test for all sorts of things but it turned out she just needed to switch to a new antibiotic. Kids with diabetes can have a hard time shaking a UTI because the bacteria feeds on the sugar in the urine, I had to really talk to my doctor to convince her not to test for other problems until we had just tackled the UTI harder with antibiotic.

    We find we sometimes need to add milk, too, instead of just fast carbs. Selah would sleep through a buffet if she needed to, it's really amazing how they adapt!
     
  15. SarahKelly

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    we found that Isaac's insulin needs are very low at night when he was on shots we'd let him go to bed at 250 because he'd drop so fast. That said he'd also need an uncovered snack that included some form of protein - either nutella toast, nutella and ritz, or soy no sugar added chocolate milk.
    This was also a reason we pushed for an insulin pump so quickly, we're now able to have his insulin down to zero for several hours like his body needs from about 2-4am and we are able to keep him in a better range with the pump, too.
     
  16. show2tj

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    syringe of syrup

    When Sebastian was younger we used the medicine syringes you get with antibiotics, drew up 5 ml (I believe that is 1 tsp) of syrup (whatever kind you like) and gave it to him slowly. Best done when he is on his side (usually he sucks it down himself, but if he doesn't he can aspirate). When he is really super tired, we will bring out the syringe -- making him eat glucose tablets is never that difficult, but ocassionally he gets tired of them and will refuse, so when he's asleep it's easy just to put the syringe in and push. Good luck!
     
  17. iva

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    Same here we used to do that with allanda n we still do it now if she happens to have a low at night. Allanda is 3 and we she's on 2units levemir at 6pm, we calculated by 0.2u/kg, so she does fine during the night with that amount, but when she was smaller she was on lantus then she used to have horrible lows during the night, just sharing me experience here hope it mite help.
     
  18. manda81

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    For nighttime lows, we usually give a juice box to bring him up, and then follow that with a spoon of peanut butter, or a cheese stick... something that will stay with him for a bit.

    After antibiotics, we always have a couple weeks of lows. I don't know if killing off the good bacteria in their intestines messes up their absorption or what... but we have to back way off the insulin anytime he's had antibiotics. I'd talk with your endo about it and see what they say, if you aren't comfortable making the adjustments on your own yet.
     
  19. ecs1516

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    I agree, seems like a lot more insulin than my kids took when they were younger
     
  20. nanhsot

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    I have not dealt with a child that young with D, so take my words with that understanding. Your scale seems much too broad to me, you are treating a 110 the same as a 190, with 1.5 units?? And a 200 gets the same amount of insulin as a 300, etc. That doesn't seem logical to me and I would talk to them about perhaps breaking the scale into smaller parts.

    I know this is all new to you but perhaps you can also talk to them about carb matching instead of a scale, where you give direct insulin to match what she is actually eating instead of the sliding scale. I'm wondering if perhaps your night time insulin is too much, and I think your lantus is definitely too high for her age.

    Many kids are more insulin sensitive at certain times of the day and it may be that what you are giving with dinner is simply too much for her and the scale needs to be modified for that time of day.

    Can you share what level of low you are seeing? Remember also that the body in honeymoon tries very hard to keep them level and it's not uncommon for them to drop at night to a "normal" level. We're told to keep them above 70 but in non diabetics sometimes 70 is normal, so her body may just be spitting out insulin at that time of night to level her naturally.

    Not to say you do not need to treat, of course you do. We treat at night generally with glucose followed by either some milk or peanut butter, I definitely agree with all who advised to give some sort of lasting carbs, something with some fat that will stick around a while. We've found chocolate milk to work well, you can also try to stir in a bit of corn starch into some milk, it stays in the system a long time but doesn't spike.
     

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