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First time glucagon

Discussion in 'Parents of Children with Type 1' started by kail, Sep 29, 2016.

  1. kail

    kail Approved members

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    Tonight DD started vomiting right after dinner. She was high going into dinner thankfully which bought us some time but she soon dropped from 200 to 50 after vomiting 8-9 times and plenty of insulin still on board. Tried honey, glucose drink, juice but she barely took a taste and then threw up and refused to do anymore. We are almost 3 years in but she has only vomited a couple of times when it happened and I think always from car sickness which wasn't so bad to handle.

    So I figured it was time to pull out the glucagon. Too bag I couldn't find the one that expires this month but popped open the new one and gave 4 units. 5-6 is the dose I saw but figured I would start low. Right now--30 min later she is 130 on dex with double arrows up!!!!! I am so relieved.

    At least we are nearly beyond the active insulin dose. Oh I just realized I haven't given lantus. Don't want to forget that.

    I'm not sure if she is sick or just got some food with gluten. She has celiac but has always been asymptomatic. But we had take out food from a restaurant and it started right after. I don't want her to be sick which could last longer but don't want to start having a bad gluten reaction either. I've heard it can happen after you have been gluten free for awhile. ☹️
     
  2. Mish

    Mish Approved members

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    We have good luck here using glucagon as a mini-dose, like you did, and not as a rescue dose. I keep all my expired ones and have success using those for this purpose. My son is much older than your daughter, but we still can get away with just 4 or 5 units, in a regular syringe. We found when he was younger that a full "mini dose" (1u for each year of age) was too much, and gave him a wicked headache the next morning. Next time, try just 2u. I think you'll be pleasantly surprised.

    We love mini-glucs.
     
  3. kail

    kail Approved members

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    I thought I would post a follow up about the rest of the night. I was so relieved when the first dose of mini glucagon brought her up to about 150 but within an hour from the time she got the glucagon she was dropping again. I tried unsuccessfully to get her to drink but I could not get her to take anything in her sleep which has never happened before. I decided to give another dose and this time did 5u. I watched her rise on dexcom up to 80 so I waited the full 30 min before checked her and found her only 58 on the meter-no better at all. Dexcom started to fall again about then too. I was about to double it and give it again but decided to wake her fully and try again orally since it had been a little while since she had vomited. I was able to wake her and get her to take some juice and smarties and it was enough to get her to come up for another hour. We continued that hourly through the night and made it through. My endo said he wasn't that surprised that the glucagon didn't work the second time since he had never really believed the reports that the glucagon would stay stable for 24 hours even in the fridge but I know that these protocols are published so I assume people must have some luck using it for repeated doses.
     
  4. Mish

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    I don't want to contradict your doctor, but I'm going to. The second dose of glucagon probably didn't work because she had used all her glycogen stores in her liver. Glucagon causes the liver to convert stored glycogen into glucose. Once the stores of glycogen are used up, the glucagon doesn't work. It takes about 24 hours of normal blood sugars to replenish the glycogen stores. It's something to keep in mind.
    http://www.diabetesselfmanagement.com/diabetes-resources/definitions/glucagon/

    The glucagon certainly wouldn't have gone bad in that amount of time (one hour). And in fact, in the Bionic Pancreas trials (Ed Damiano's version) using glucagon in addition to insulin, regular constituted glucagon was used and changed daily. It lasted at least 24 hours in the pump. :)
     
    Last edited: Oct 3, 2016
  5. rgcainmd

    rgcainmd Approved members

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    Wish we had a "LIKE" button!
     

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