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Mini-Glucagon dosing

Discussion in 'Parents of Children with Type 1' started by MomofSweetOne, Jan 3, 2012.

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  1. MomofSweetOne

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    We've never been taught about mini-glucagon dosing, so I'm wondering if someone can explain it. I've read enough posts that I realize it's for severe lows that aren't coming up, but do you then need to get lots of carbs in before the liver pulls the sugar back in? And how much do you use? How does it affect the kids? Thanks for your help!
     
  2. Brenda

    Brenda Junior Member

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    Here's a page to get you started:

    http://www.childrenwithdiabetes.com/d_0j_20w.htm

    I think you do need to give carbs over the following days to help restore the stored glucose. The dose is used mainly when you have a sick child with very low or dropping blood sugars and they cannot or will not consume carbs because they are feeling ill/vomiting. I don't know that there is any set amount you need to give. Once your child feels well, they will eat as usual and the glucose storage will resume. Though I have no personal experience with it, I think you only have issues if you continue to give the mini dose multiple times over a short time span. Hopefully, someone with personal experience will respond. And, for those who do have that experience, sorry you had to go through this. :(
     
  3. danismom79

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    I was instructed to give 1u per year of age, but I don't know if there's a limit.
     
  4. Flutterby

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    1u per year of age, but we adjust that for whats going on... if she's sick and in a presistent low, we stick with the 1u per , if she's low but not sick we back off because the 1u per year does sent her pretty high... we don't correct that high for a while, givng the body time to take back what it wants..
     
  5. Freudie1

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    This is not only a bad idea, its a band aid to a problem.

    You need to identify WHY you are having severe lows and adjust your dosages (either basal rates if you are a pumper or long acting insulin if you are using injections).

    What endo did you go to that recommended such a thing? I doubt any.

    Quick advice for flus/illness from a Dad that has 2 T1 kids under 10:

    Blood glucose levels will typically rise naturally even when sick assuming you have reduced/stopped/etc the insulin levels. If (and lord forbid as I greatly sympathize) you are using garbage like Lantus, indeed you have the "ticking time bomb" to fight until that wears out, however if you are fortunate enough to be a pumper, you can generally reduce the basal (or turn it off temporarily) to get your kid through the period of no eatting/puking/etc. We have NEVER (and yes I understand some people think we are lucky) had to go to the hospital with flu or colds using this strategy.
     
  6. mmgirls

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    What a very rude way to respond.

    This is a very common practice within the T1 community, many amny parents, caregivers and Dr., nurses, CDEs, what have you have made this recommendation and have saved a family from a trip to the ER and or stabalised a T1 before going in for additional help.

    A mini dose is used during sickness, I suspect 90% of the time duing a sickness that included vommitting. At that time almost suddenly the stomache many stop absorbing carbs and severe lows can happen to the unknowing person.

    I have never used the mini glucagon, but was given the directions of 1Unit per age in years. That was over 3yrs ago with my 3yr old during a stomache bug.
     
  7. Freudie1

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    I'm sorry you felt that was rude. I have two T1 children under the age of 10 (one being diagnosed for >4 years now) and have never heard an endo/etc recommend this. In fact we have been told repeatedly that glucagon is reserved for emergencies only.

    If you are using glucagon for anything but a last minute emergency I still maintain you need to look closer at your basal rates (or long acting insulin dosages assuming you are not a pumper) to resolve this. Fighting the good fight with glucagon is definitely not what I would/do do.
     
  8. Jeff

    Jeff Founder, CWD

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    Mini-dose glucagon rescue is used to help prevent a severe low in cases where insulin is on board and the person is vomiting or otherwise unable to keep food down -- or when they have taken Symlin or Victoza and the rapid acting glucose isn't acting rapidly enough.

    The key word is mini-dose. You mix up the glucagon and inject a very small amount using an insulin syringe. Dosing guidelines are based on weight/age and can be found here:

    http://www.childrenwithdiabetes.com/d_0j_20w.htm
     
  9. Michelle'sMom

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    Thank you Jeff. Our endo absolutely approves the use of min-dose glucagon.
     
  10. Lee

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    Niiiccceeee...

    Who are you? Thank you for insulting me.
     
  11. Jeff

    Jeff Founder, CWD

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    For patients using MDI, Lantus is a fine basal insulin.

    Why would anyone think otherwise?
     
  12. Beach bum

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    Well, you've just made a lot of the new people who have recently joined feel really great about what they are giving their kids. Lantus is not a ticking time bomb. Nor is it garbage.

    There is absolutely nothing wrong with using MDI, so don't knock it. If it works for people, let them use it without criticizing them. Did you ever think that there are some out there who are not fortunate enough to have insurance to cover a pump? Or, MDI is working nicely for them?

    Can you give us some proof that Lantus is garbage and why it's a ticking time bomb?

    And FYI lord is spelled Lord. You are referring to a higher being by name.
     
  13. MamaC

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    I think (and hope) that you are trying to be helpful. As the mother of a CWD who uses Lantus, and who is fortunate enough to be able to pump but chooses not to, I think your advice would be more easily accepted with a downward revision in tone and delivery. (And yes, out highly esteemed endo does recommend mini-dose for her smaller, younger patients.)
     
  14. Flutterby

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    I don't think I've read a ruder post in a long time. You are new to this site (well, your user name is), one of your first posts is full of insults? Calling insulin garbage is ridiculous, that 'garbage' keeps kids alive.

    I've heard from many Endos, cde and other parents of kids with t1 about using minidoses of glucagon, and infact I'm SURE its saved my child from having to go to the ER via an ambulance on more than one occassion... and she uses a pump, imgine that!
     
  15. Flutterby

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    Mini dose of glucagon IS to be used in an emergency, when a child is still awake but when a won't come up. I'm so glad that you seem to have everything completely undercontrol but for the rest of us, illnesses come on quci, its not a basal/ratio problem, its an ILLNESS. Or for someone like my child who also has celiac and when ingesting gluten on accident it causes her to go low, for long periods of time. Again, this is something that we can NOT predict and doesn't help with reducing basals. A mini dose of glucagon will NOT deplete the bodies stores of glucose, a MINI dose helps the glucose rise when there are absorbtion issues, and something needs to be done ASAP. For most people reducing basals, even on a pump, takes a while to kick in, sorry, but I'm not letting my child sit in the 30s while her reduced basal is waiting to kick in.. THAT is far worse for a child than giving a MINI dose of glucagon. :rolleyes:
     
  16. Freudie1

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    Relax

    First, let me respond to several of you to say this. Indeed I am trying to help. If you don't care for my tone or words of experience that is your choice. I'm not here to make friends or be your doctor. I simply joined to share some info about the MySentry device that I've been following for a few years. I figured along the way I would chime in with some of MY experience with 2 T1 kids.

    Second, to the person criticizing my usage of the word "lord", get a grip and keep your bible to yourself.

    Third, since apparently I struck a sore spot with many using the words "Lantus" and "garbage" in a single sentence here are some brief thoughts on it from a parent that lived with it for over a year:

    Lantus is a "long-acting" insulin in laymen's terms. It is SUPPOSED to be given once per approximate 24 hour period (correct me on the time as we haven't used it in years so my math is likely off on that schedule) traditionally (I say supposed as I have read some fairly wacky posts stating usage of Lantus in very off the prescribed methodology path, but I digress).

    Based on MY experience (and once again I stress that fact), Lantus was/is indeed a ticking time bomb. Why? Here goes:

    So at 8PM right before bed we would inject our next round of Lantus. Great right? Not really and here is why:

    You now have insulin "on-board" for at least the amount of time it takes for the Lantus to fully distribute/perform. For our oldest that was almost 24 hours for certain.

    If your son/daughter gets sick, won't eat, hates food, decides to be objectionable that day then you are indeed dealing with a "ticking bomb". How so you may say? Simple, unlike basal rates with fast acting insulin, the Lantus (and please note, I am ONLY using Lantus as an example of a long-acting insulin, not an attack on a specific brand, just the methodology/type of insulin) you have this to deal with until it "wears out" (my term of course).

    So, imagine you just gave the Lantus injection. Your kid wakes up 4 hours later and throws up. He/She is running low, lets say 65. You have two choices with this scenario:

    Give the child juice, honey, etc OR give glucagon if the child will/won't eat either. This my friends begins the first revelation of why long-acting insulin WORKS, but has major draw backs.

    Want more examples? Ever notice that if you sneeze in the wrong direction of the graduated marking on your highly inaccurate syringe when injecting Lantus that you can have wildly different results for the next approximate 24 hours? It can and does happen.

    Solution: Its the pump. Using any long acting insulin for a T1 is (IN MY OPINION), an antiquated management methodology. Yes I understand not everyone is "fortunate" to have a pump (I can write a whole book on why I don't agree with that by the way but that will be saved for another time), however I think on the whole most parents and endo's/etc do a very poor job of understanding or teaching the limitations and dangers of this method.

    All comes back to the original topic of this thread. When my kids go low I either reduce their basal or turn it off. The only time we have come close to even having to consider cracking open the glucagon kit (and at $150 a kit I might add) is when we bolused, she got sick 30 minutes later, and we fortunately were able to keep juice down. If we had long-acting insulin on board what would we have done? Turn it off? Oh yeah, thats right...you CAN NOT.

    Bottom line: I don't care if you agree with this post. In fact, please ignore it. However, for the few people out there that this might help (or even better realize this is coming from a very informed and experience Dad of two T1 daughters) I am glad to have helped. I don't and won't apologize for my tone as I feel very passionate about this. If you want to defend Lantus because (for whatever reason) you can't/don't have the pump, thats your right. However, in my opinion its ignorant.
     
  17. azdrews

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    Wow. Never in my time in the online diabetes community have I seen such a rude statement. Just. Wow. Glad to know that you have everything figured out when it comes to diabetes. Perhaps you could teach a class so the rest of us can learn how to do it the "right" way?

    We have used mini-glucagon, and yes, it was recommended by our endo (who is very well respected, thankyouverymuch) At the beginning of our pumping experience, we over-corrected and mis-counted carbs (OMG, we made a MISTAKE!) and our 4 year old refused to eat or drink anything more (he was too full and felt sick.) Rather than take him to the ER and waste time, money and energy, we used a few units of glucagon to help bring up to a safe range. Now, please tell me how that is irresponsible??
     
  18. Freudie1

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    Yes because I certainly implied that using Glucagon is never necessary right? Read my posts again and note that I was responding solely to the originator of this thread.

    Glucagon has a purpose. Using it to manage NON-EMERGENCY lows it is not for. That was my intention and message.

    As for Lantus...keep reading. It is in my opinion an ancient and dangerous alternative to the pump. Does it work? Sure. I know this personally. Are there much safer and better options? Sure is. Its called the pump your daughter is using.

    Thanks for agreeing with me.
     
  19. Freudie1

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    Once again, where did I say that Glucagon is NOT for emergencies? I'm responding to people claiming it is used to manage non-emergency lows. That is all I was saying. You going on a tangent about celiac, lows, etc are understood, but not what I was responding to. Indeed as I have posted, I agree that in EMERGENCY situations Glucagon is needed.
     
  20. Lee

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    I think you are the biggest *** I have ever seen here - thank you for sharing your experience, but please feel free to keep your 'help' to yourself. Many of us here can offer advice without being condescending and many of us here have multiple years/multiple Type 1's - the way you care for your children works best for you, but don't insult others methods.

    ETA: And for the life of me, I cannot understand why you came here to share info about the Sentry and then stayed to insult so many people.
     
    Last edited: Jan 4, 2012
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