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Low blood glucose scare today.

Discussion in 'Parents of Children with Type 1' started by Serenia, Jun 26, 2012.

  1. Serenia

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    The diabetes nurse had planned my sons meals as follows -

    breakfast 8 am
    Snack 10.15 (right before 10.30 am recess at school)
    Lunch 12
    snack 4 pm (when he got home)
    dinner 6 pm
    snack 8 pm (bedtime)

    for the last week since he was dx'd this has worked well for us - until today.

    At 3.30 pm right when my sons school gets out for the day I got a phone call from the school right on 3.30.

    My son is feeling shakey - what does he need to have?

    Me - He needs sugar ASAP.
    Does anyone have any juice or pop?
    Does he have a packet of dextrose 4 glucose tablets in his bag?
    The answer to both those questions was NO.

    So I rushed down to the school taking some juice boxes with me.

    He looked fine when I got there - the office gave him some small pastries because they have sugar.

    I measured his BG - it was 2.5 mmol/L - which is very low. The usual range for mmol/L is 4 -7 for adults and 4-10 for kids.

    So I gave him 2 juice boxes. within 5 minutes his BG was back up to 4.7 and by the time we got home, it was up to 6.2 mmol/L which is good.

    He had been running around for the last hour before home time, from 2.30 recess until the home bell at 3.30pm which is why his BG went so low.

    Now I will have to watch and see that he doesnt go too high before I can give him the next insulin which he usually gets at 6 - thats one hour from now.

    We discovered the dextrose 4 glucose packet in his lunch bag which he had left at home.

    I gave the left over juice boxes to the staff - there are only 2 more days of school left.

    There is a meeting planned with the staff for diabetes education tomorrow and I was planning to tell them about all this - but at least now they have had a "practice situation".

    I was telling my son he did exactly the right thing - to go to the office instead of trying to walk home. The only reason why I hadnt supplied the school with any emergency stuff is because we dont have any money to purchase it except the juice boxes that happened to be handy. We had purchased those for his lunch right before he was dx'd as type 1 - so they have never been used. Now he has milk for his drink rather than juice.

    This is not a rant - its just me leaning from our mistakes.

    Now I know that he must have some carbs at 2.15 pm before the afternoon recess. The trouble is that we never know when the kids are going to be outside - its one of those things that cannot always be planned for. But more carbs before exercise sounds like a great idea.
     
  2. emm142

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    It's fine to vent here when something scary or annoying happens with D, so you shouldn't worry about that.

    You're right that 2.5 is pretty low.

    1. It's lower than I go on a regular basis - in fact, I'm sure it has been several months since I was that low.
    2. I have been a lot lower (below 1.1mmol several times, and in the 1-2mmol range several times) and been able to self-treat, no loss of consciousness etc.

    Both of those things are intended to reassure you. Once you've got carb counting down and established some basic routine (snacks before exercise, etc.) hopefully you won't have a lot of lows like this. He might also get better at learning any warning signs of low BG that he feels, so you might be able to catch them earlier. Plus, eventually they won't be too scary; you'll be able to treat and move on.
     
  3. Serenia

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    Ok just did the 6 pm (dinner time) finger poke and insulin. He has just had novorapid insulin.

    His BG is up to 14.8 mmol - but thats probably due to the pastries plus 2 juice boxes he had in addition to the 4 pm snack he had - too much carbs.

    I guess its usual for BG's to yo-yo like that when recovering from a low. They had been nice all low all day yesterday and this morning until the school called me.

    But yes we are on a strict regime here. I think the nurse is waiting to see if we are going into the honey moon period... so this is a second low 2 days in a row. I will of course report this whole episode to the nurse and see what she says.
     
  4. emm142

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    Yeah, 2 juice boxes was probably too many carbs. Depending on the size of your juice boxes I'm guessing that was circa 40g, which would be enough to raise me by about 22mmol (so up to 25mmol/l) but I am very sensitive to carbs, so for others it might raise them by more like 10-15mmol, which fits more with what you saw.

    Another aside, I've found that juice is not the fastest acting carb for me, especially during a bad low. I'm better to stick with purer glucose (tabs, gel, candy, etc.). If I were 2.5mmol/l, depending on other factors such as rate of drop and activity, I'd probably go for 15g carbs of tabs, gel or candy.

    You'll learn what works as you go on. Also, it will never be perfect. I hit 15mmol/l most days, and I'm basically out of growing and puberty, so things should theoretically be easier for me. So you will learn how to do the best you can, and you will also learn what aims are achievable. These early days are intense and new and completely crazy. Coming up on 5 years now, it's a lot more routine. Much as D is a huge pain, I'm pretty grounded in dealing with it.
     
  5. PAULEEN

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    Good job mom ! You did just fine. As Emma said pure glucose may work faster then juice with such a low. In time you will figure out what works best for your child. It does get easier as time goes by. Your son did a great job too! Both of you keep up the good work.
     
  6. MamaLibby

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    I agree! I know it's scary, but like Emma said, it does and will get easier. My daughter has been living with D for 8.5 years now, and it's like elevator music. Annoying, hard to listen to, but in the background of the ride :D
     
  7. danismom79

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    In time, you'll learn how much it takes to bring up a low. I think we've all overtreated at some point or another, especially in the beginning.

    My daughter started on an NPH regimen, and although she never had a honeymoon, her insulin needs did go way down within weeks of dx. How is he handling the food? Is it too much?
     
  8. PAULEEN

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    LOVE THIS!!! Great quote.:)
     
  9. emm142

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    I think I'd rather live with D than with constant elevator music. :eek::p
     
  10. Serenia

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    I giggled at the elevator music quote

    But I have to agree with Emma. elevator music 24/7 would eventually drive me nuts.

    I can handle the yo-yo's and I know I did good today. So I am pleased with myself. for knowing what to do, for not panicking and for knowing what to tell the office staff and the principal. The principal told me she has no experience of having any D students in any of her schools, although she is aware of D students in other schools.

    She also was not impressed that the school board has NO Specific policy regarding D students - each school gets to make its own policy....

    My son's bedtime BG was back down to 9.9 so we are doing good. :D

    He has had his long lasting night time insulin and is currently eating his bedtime snack.
     
  11. Helenmomofsporty13yearold

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    Have you visited the nearest chapter of the Canadian Diabetes Association? I found them very knowledgeable and very helpful when my daughter was diagnosed. They may be able to help you with supplies or at the very least point you to how you can get help.

    It is very important to have extra carbs when exercising. The general rule of thumb is 15 extra carbs for every half hour of exercise.

    The candies called "Rockets" are made of Dextrose and much less expensive than the Dex tabs. You can get a bag of 20 rolls for $1.00 at Dollarama. Each roll is 7 carbs.
     
  12. Serenia

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    Ooh thats very useful to know. My son doesnt particularly like Rockets - but I do!! :D

    But I might buy some from the dollarama for school anyway. Thank you for that info!! :)

    Have been too busy to go visit the CDA yet...THats gonna have to wait until next week.
     
  13. Sarah Maddie's Mom

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    It's worth remembering that it's a treatment, not a treat. My daughter doesn't particularly like glucose tabs but she uses them to treat lows because they are fast and reliable and convenient to carry.
     
  14. DsMom

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    Love this analogy!:):)
     
  15. Deal

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    Serenia, an idea for you as a cheap alternative to glucose tabs. The Halloween treat 'Rockets' are pure glucose as well. Often you can buy the super size packages in the dollar store or bulk barn type stores. That's what we use in all our emergency kits. Cake decorating gel is another good alternative but not as cheap. Just squeeze it in his mouth if required.

    ooops: This is what happens when you don't read all the replies before posting.... my bad
     
    Last edited: Jun 27, 2012
  16. Serenia

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    Thats OK. I think rockets are a great idea and I will be implementing that for summer camp and for school next year.

    I will try and find some glucose gel as well. I have also seen mention of tubes of cake frosting too - is this right?
     
  17. danismom79

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    I do keep tubes of glucose gel around in case my daughter were unable to chew or drink (you could squeeze it into the mouth and rub into the cheeks), but for everyday lows, we use glucose tabs. We used to get Skittles, but I've gone away from the candy, for the most part.
     

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