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 doctorâŚwhich should be ASAP for peace of mind.
It is better to post numbers, as âlowâ 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 werenât splitting it. She isnât 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 itâs 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.
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 Iâm doing this math correct. Iâm using the dexcom g6 and itâs was already low at 3.6 and arrows indicating that itâs 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?
Iâve tried reaching out to the Dr but she is on holiday and will only return the 26th of this month.
My daughterâs sugars are behaving fine, and she is fine when is goes to bed on a sugar of 10 mmol/l
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, Iâd 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 Iâd call it off and treat and Iâd 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.
One thing, she isnât 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 wonât wake.
Learn about sick day rules before she is fully insulin dependant. Itâs easier than waiting till 4 in the morning, with her throwing up from virus,
I wouldnât 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.
@jack16 makes a good point. While Dexcom is the standard, it isnât 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.
Iâm 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. Itâs also not uncommon for a âsputteringâ pancreas to periodically give a burst of insulin which can surprise even people who are expecting it.
@jack16âs 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.
