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Please carry glucagon, you never know...

Discussion in 'Parents of Children with Type 1' started by missmakaliasmomma, May 9, 2014.

  1. wilf

    wilf Approved members

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    You've made a pretty snippy post, and it really wasn't warranted.

    I'm hoping you can grasp that there is a difference between "running someone high" to the point where their life expectancy will be diminished, and easing off on overaggressive blood glucose targets enough for a child to be safe from bad lows.

    This is a child who has had lows in the low 20s a few times in the last year and has 1:1 nurse accompaniment at school - and she still went low enough to pass out during her lunch break. An incident like that can be pretty traumatic for a kid.

    Looking at this from the outside, I'm perceiving a need to ease up a bit on the school day blood sugar targets. That's all. Try a target of 130 instead of 120 (and do negative corrections when blood sugars are low at mealtime), and see how that works out.. :cwds:
     
  2. Ali

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    Good ideas.
    Ali
     
  3. Darryl

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    We practice really tight BG control and have only ever seen a BG in 20's once that I can recall (a 27 a few years ago). I agree with Wilf and others that this could be a risk and a change is needed. An alternative to running BG's higher, though, is testing or a CGM. Also making sure that when she is more than a little but low, she uses glucose (not juice, which is much slower) to bring up the low.
     
  4. mmgirls

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    You know, I had a very young one DX'ed. And if had not discovered this site a good few year later I would have never known from from my "education" that seeing consistently in the 200's was not ideal. And that spikes over 300' s should not be the norm and the exception.

    So I get it.

    Especially because I see parents everyday making choices because they are more comfortable with the highs than the lows. And I can not fault them. We are getting better at seeing the sighns of T1D, and so much more often we are hoping that our kiddo will go into a good strong honeymoon.

    The education that we get at the get go, focuses on lows, yet does not express that a bg in the 80's is perfectly normal. Not something to be scared about unless there is too much insulin or activety deal with it well.

    I do not think a target of 120 or even 100 is too low, but rather the results of targeting at those numbers.

    The OP needs to look at what the literature says and compare to the population here and find a happy medium. If you where to poll the population here on CWD, I will bet you that in the last year or two that very few have seen bg ' s in the 20's unrelated to illness.
     
  5. wilf

    wilf Approved members

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    I guess I see this differently. If for a given child on their given insulin regimen there are several lows in the low 20s (one resulting in loss of consciousness) in the space of one year - then there is a problem with the regimen. Change of some kind is necessary.

    There are several things you can do to change things, including getting a CGM as Daryl has pointed out. In the absence of a CGM, you could go for more frequent supervision by a nurse - but this child already has constant supervision.

    Something has to give, and in my view all you reasonably can do at this point is ease up a bit on the target BG during the school day.
     
  6. virgo39

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    I think every parent is aware of the benefits of good control; however, I agree that with those kind of lows, something needs to be changed. In addition to a CGM or more frequent BG checks, one could, as wilf notes, adjust the target BG. Perhaps the 1:15 insulin-to-carb ratio at school could be tweaked (or the breakfast I:C ratio)? And it may be that the correction factor and basal could also modified (one could split the basal, etc.).
     

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