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Anybody Ever Had A Low Like This?How Did You Handle It?

Discussion in 'Parents of Children with Type 1' started by wearingtaci, Nov 22, 2014.

  1. wearingtaci

    wearingtaci Approved members

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    I'm up for the 1st night shift of Dex watching. Sophie had/has a bit of a tummy bug. She vomited and her blood sugar started to drop. First we gave her 3 glucose tabs and she 15 minutes later she was stable at 69. So we gave her 8oz of regular Ginger Ale,then a big tube of icing,then a spoonfulof honey,separated by 15 minutes each.Set a temp basal for 80% for 2 hours.Still in the mid 60s. I call the CDE and wait,no call back so I call the 24/7 nurse line and they suggest we call 911 to transport to the ER. I say let me try a mini Glucagon first. So after 12 units of Glucagon she comes up to the mid 90s and is more with it Now at 1.5 hours after glucagon she is trending down again and I set a temp basal for 75% for 2 more hours If she goes low again and I can't get her back up fast I will have to call 911.
    What would others with more experience have done?Lower temp basal,how low do you start? I'd hate to over correct and run the risk of DKA
    I know stomach issues suck for T1D,but this is insane
     
  2. wearingtaci

    wearingtaci Approved members

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    It gets weirder. She has vomited a few times and each time her bs goes up a little bit. Of course it all happens the night I really need sleep
     
  3. KHS22

    KHS22 Approved members

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    It really depends, but here, we needed under 50% temp basal during bugs... She won't go into DKA that quick, you are monitoring her, including ketones I assume - if she starts going up up and has ketones, you correct. I'd be a bit more aggressive with the lowering basal if she keeps going low.

    And, I hear ya. Always happens nights you really need to sleep...

    Hang in there..
     
  4. StacyMM

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    For stomach bugs, I turn basals down about 50% and push Gatorade. They can usually keep it down in small sips and it gives thems enough carbs to keep them up. And, even though the bug may pass in a day or two, they usually need less insulin for several days after.
     
  5. wilf

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    Vomiting causes blood sugars to rise a little.
     
  6. wilf

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    You can give a bit more in the way of mini-glucagon.

    Basals can be reduced further. The process leading to DKA is triggered when there is zero insulin in the bloodstream. As long as she has some insulin coming in and BG levels are low you're ok.
     
  7. Nancy in VA

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    When we have super stubborn lows we will sometimes turn off basal for an hour - just to get a bit of a spike, and then work to bring it down slowly. Sometimes they just don't want to respond to the sugar until much later - and then we see a super spike! But hey, even Emma knows that we'd much rather deal with bringing down highs than lows - she knows our motto is "high is better than low"
     
  8. dpr

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    I start at 80% and if the low keeps going I keep dropping 15%-20% every 45 minutes or so. If it seems like I can't get it her to come up then I handle it pretty much the way Nancy does. I'll go to 0 for a half hour and then to go with something like 20%-30% basal for another half hour so there is a small amount of insulin. We still get the spike later, but I'm more concerned with keytones from 0 insulin for too long if she's sick. I'd rather deal with bringing down high than worrying about a constant low.
     

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