Diabetes Type 1 lows without insulin

Hi Guys,

I am new here and really hoping I could get some piece of mind. My 6 year old daughter was diagnosed with diabetes type 1 a few months ago. Since then we have been trying our best to manage her sugars as well we can. It is difficult though.

My daughter is not on any insulin at night. The dr says this is due to her being in a honeymoon stage. Her sugars remain stable throughout the night, however, during a certain time in the night she tends to drop relatively low and we are having to wake her up to give her something to bring the sugars back up. My question is this, is it normal for sugars to drop without any insulin medications? Can her insulin be working so well, maybe too well resulting in dropping her sugars?

Until you can contact your doctor…which should be ASAP for peace of mind.
It is better to post numbers, as ‘low’ means different numbers to different people.

Your child is just using a short acting bolus mealtime insulin and not a long acting basal insulin, as well. You weren’t splitting it. She isn’t getting a long acting of a morning.

What are you calling low? Kids not on insulin can drop lower and be alright. Ask your doctor if 60 and not the T1 70, would be OK in this case, with no insulin onboard The mealtime insulin has passed it’s action time.

After meals, when she has received an injection, you would use a higher range and have 70, 80 or more as the min target. Depending on your doctor. Some like more of a buffer.

A supper with more protein and fats may help. This will release glucose over a longer time.

I would also look for kid groups on FB, Or forums with an active kids section. With lower carb and higher protein, some need to bolus for a percent of the protein. This could be a thread for another day, or google TAG, total available glucose.

Hi Jack

Thank you for your reply.

When she went to bed her sugars were at 5 mmol/l or 90 mg/dl

Her sugar was around 3.6 mmol/l which translates to 64 mg/dl when she woke up if I’m doing this math correct. I’m using the dexcom g6 and it’s was already low at 3.6 and arrows indicating that it’s still dropping. What happened after kind of boggled my mind. I gave quick acting carbs to bring the sugar up, and while this worked in sending the sugar up, it brought it back down again, having me to react with quick acting carbs again. This without any insulin.

My assumption is that she is in a honeymoon period which is what the Dr advised previously, this ofcos resulting in us not having to give any long acting insulin at night. But is it normal, in diabetes type 1 for sugars to drop extremely low without insulin during the night in the honeymoon phase? Could it be that the dexcom was giving inaccurate readings perhaps?

I’ve tried reaching out to the Dr but she is on holiday and will only return the 26th of this month.

My daughter’s sugars are behaving fine, and she is fine when is goes to bed on a sugar of 10 mmol/l

I appreciate your advise thank you

Ask your doctor first, this is the internet. He may choose to put her in hospital overnight to monitor.
If it was my child, 3.6, I’d leave it and stay awake and monitor, it should level off. You might choose 3.3 to treat and refer back to the doctor. 3 would scare me and I’d call it off and treat and I’d be on the phone to the doctor. In A&E, clinical hypo of a child is 40/2.2 adult male 50/2.8

She may have released insulin in response to the quick carbs and sugar crashed. You need to backup with slower carbs or with protein/fats too. When she has injected and has insulin onboard, you use quick carbs, because she will keep falling and could hypo.

Can you attend a T1 course at the hospital? what country are you in. we use mmol/l in australia.

this overview may help


insulin

One thing, she isn’t laying on the sensor when she goes into a low period? You could do a finger prick test to confirm. A bit of luck and she won’t wake.

Learn about sick day rules before she is fully insulin dependant. It’s easier than waiting till 4 in the morning, with her throwing up from virus,

I wouldn’t use the amount of carbs they are feeding the kids in the booket linked above. I would lower the carb amount.
If you can maintain good BG you may not need this low.

6 months of BG

1 Like

@jack16 makes a good point. While Dexcom is the standard, it isn’t infallible. Always verify a low (if possible) with a fingerstick (or two). The same goes for a very high high. Compression lows when sleeping are also a thing. Sleeping on the sensor/transmitter can at times give false lows - extremely false lows.

I’m not suggesting that this is the only answer, your doctor would be the person to consult as he/she has a better understanding of the complete picture. It’s also not uncommon for a “sputtering” pancreas to periodically give a burst of insulin which can surprise even people who are expecting it.

@jack16’s suggestion of an increased protein/fat meal at night will also help to stabilize overnight bgs since protein and fat take longer to digest than simple carbs. A nutritionist would also be able to help you devise a mealplan with variables to help mitigate the on again/off again pancreatic function you are experiencing.

Let us know how things are going, and if we can help by pointing you to resources if needed/wanted.