Sick T1 Toddler (2 Year old)

So it looks like whatever I have (very bad congestion, hacking, etc.,) has been handed off to my 2 year old T1 son. Is there anything I need to know as far as care for this period? What changes can I expect to experience in his BG levels? Anyone have any advice/recommendations, I’d love to hear them. We will definitely keep him hydrated.

Thanks!

good video

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Read up on how to use mini glucagon if this becomes necessary.

http://www.childrenwithdiabetes.com/d_0j_20w.htm

Yep, we have an emergency glucagon injection needle and went through training on how to use it. It’s the one thing in our D-kit that we hope we never have to use!

Thanks! Great video!

Sounds like a respiratory sickness, but be aware of stomach bugs–as they are especially tricky.

@ClaudandDaye, when you were trained on glucagon did they teach you how to use a mini-dose? It’s a small amount of glucagon injected with a regular insulin syringe. If you weren’t taught how to use it, I would highly recommend you read up on it.

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Thank you, TiaE; that’s the link I was looking for! Using mini-glucagon saved our butts once when my daughter couldn’t keep anything down, before Zofran kicked in.

Which reminds me, a supply of Zofran (Ondansetron) is a must-have to keep in your sick-day arsenal. You should ask your son’s endo or pediatrician for a rx.

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I never even heard about doing that until I joined this forum.

That is a great article, @tiaE, thanks for it! I’ve bookmarked it. I do have a question, though…we were only given a single glucagon kit. Are they something we can request more of? Do we have to pay out of pocket for the extra(s)? If we use the glucagon for the purposes mentioned in the article, it sounds like the glucagon is pretty much shot 24 hours later.

When my son doesn’t want to eat, we often (maybe we shouldn’t) cave in and give him “bad carbs” (chips, Popsicle, etc., just to make sure he gets the carbs he needs.) If I read the article correctly, this “mini dose” isn’t something you just give your child anytime they just aren’t eating for whatever reason…it’s only if they are sick with some stomach bug? The article references “or an obstinate child who refuses to eat or drink”…but we can always get our son to eat SOMETHING…it’s just WHAT, that’s the challenge…as I said, many times, we just give in and get him something he probably shouldn’t have…just so that he EATS, and the carb challenge is met for that meal.

Would like clarification on WHEN this process (in reality) should be used? Also, about the kits…are they something we can just request more of?? We were only given (and still only have) the one that we were given during the time he was diagnosed, before we left the hospital and we’ve thankfully not had to use it yet.

Also @rgcainmd, thanks for the tip on the Zofran! I’ve made a note!

-H

We learned about mini-dose glucagon from Dr Ponder. Its one of the most useful tips weve received.

Our Rx is written for 3 glucagon kits. We’ve used the mini-dose many times over the years, usually during stomach bugs. My daughter is in the minority. She was rarely sick prior to the T1 dx. Since then, she catches anything going around. That said, according to Dr Ponder (from the link above):
"But there is a novel use that all families should know about where a “mini-dose” of glucagon is used to treat a mild low blood sugar in a child who is unwilling to eat or drink due to nausea from a stomach bug or in an obstinate youngster who refuses to eat or drink. "

It’s not a very cost effective method, but works quite well. After mixing, the glucagon vial can be refrigerated & used for 24 hrs. The mini-dose doesn’t cause the typical side effects (nausea) of a rescue dose.

Btw, Popsicles are still on my list of sick day items. I always have at least a couple in the freezer. They’re a great way to get carbs into a sick kiddo (or adult😊). With the little ones, you give them whatever they’ll take.

Unfortunately, you have the added burden of having a toddler with T1D who, like most toddlers, refuse to eat what we have planned for them or what they have asked for. Personally, if my daughter had been dx’d at such a tender age, I would not have used mini-glucagon for failure-to-clean-your-plate lows. We use mini-glucagon only if my daughter has (temporarily) intractable vomiting and is going double-arrows-down low. This is where a pump is really going to come in handy: if my Tikva had been a toddler when she was dx’d, I’m sure I would have utilized the extended bolus feature on her pump like it was going out of style to pre-bolus up front for some percentage of the carbs in her planned meal while programming her pump to deliver the remainder of the bolus in an extended fashion, say over an hour (give or take). Then, if (when) she didn’t want to finish her meal, I’d cancel the remaining extended bolus. You can still do the old-school version of this until you get the pump by injecting, say 50% for example, of the calculated bolus based on total carbs (minus grams of fiber if you do that) before your son begins eating, then inject the remaining appropriate amount of insulin (total amount originally calculated for the entire meal minus amount injected as a pre-bolus minus insulin that would have covered what he didn’t eat) after his meal. If your son routinely eats less than 50% of what’s on his plate, adjust your pre-bolus amount accordingly. I’d try to avoid establishing a pattern of “eating to the insulin” as much as is humanly possible to avoid weight and eating-disorder issues down the road (and that road gets traveled much quicker than we think it will!)

Regarding the glucagon kits, we’ve always gotten a rx for at least two of them because we used to always keep one at home, one at school, one with me, and one in my daughter’s D-purse. Her father never had one as it was pointless because he’s never checked her BG via fingerstick (and never learned how to use her Dexcom) and has administered exactly one insulin injection since she was discharged from the hospital after her dx because learning about his daughter’s Type 1 is clearly just too much effort. Because my daughter is “independent” with her D care whenever I’m not in her physical presence (and more and more of the time even when I am) and because I continue to naggingly monitor her BG with Dexcom Share and text her whenever she needs to correct or treat, we currently have only two (unexpired) glucagon kits at a time: one with me and one with her or whoever I’ve instructed on its use if she is away from me on a trip. I heard one parent plus one adult say that once you prepare the glucagon, it stays potent (enough) if you keep it refrigerated for up to several days. Knock wood, we’ve only had to use mini-glucagon twice. I’ve always filled a rx for another glucagon kit after using one (even at my own expense). Also, you didn’t hear it here, but those kits are still good enough for mini-glucagon use long after the expiration date. (If memory serves, I believe we used one for mini-glucagon purposes around 8 months after its expiry date.) I never discard expired glucagon kits; I stockpile them in preparation for the Zombie Apocalypse (it’s only a matter of time) because who knows how long that stuff may actually be even partially useful once there’s no more being manufactured and all the pharmacies on earth have been picked clean by looters (myself included). I would never, repeat NEVER, use an expired glucagon kit on my daughter if she lost consciousness or began seizing due to a low BG, however (unless we’re talking ZA and no other choice).

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This is the pre-webinar slide deck Dr Ponder used in a sick day webinar a few years ago. There’s a good list of sick day items to keep on hand (compiled with suggestions from several parents who, as he says “are in the trenches.”

This webinar is similar to the one I attended. They had a few audio issues at the beginning.

Got you beat: I never heard about mini-glucagon until I joined the CWD Forum, which was before I joined this Forum (I just didn’t know any better back then). So I guess that makes me a better D-parent than you, neener neener neener! :wink::stuck_out_tongue_winking_eye:

TiaE, thank you, once again, for posting this! You are such a great resource!!!

It’s It’s a shame he doesn’t do the webinar now. They were a great resource. I’m grateful to have been able to participate, & even more grateful he’s made them available online. I have the video posted earlier in this discussion on DVD. Dr Ponder was kind enough to give us free copies.:blush: I still watch it from time to time as a refresher.

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Which reminds me (duh!) that I’ve been meaning to suggest that you get and read (if you haven’t already) the most recent edition of Ragnar Hanas’s book:

Zombie apocalypse. rofl…definitely made from the same mold, you and I. lol. I’m for stockpiling also…a “little” help is better than no help in the event of an emergency. Regarding your hubby - so sorry to hear about that. :frowning: If my wife and I weren’t in this battle together I don’t know how one or the other of us could do it alone…it’s tough even with 2 tbh. It sounds like your daughter is at the point now where she’s capable and that’s awesome! Our 2 year old is helpful for us right now as much as he can be. We ask him “Which finger” and he’ll hold up the finger he’s OK with us pricking for the sugar checks. We also ask him where he wants his shots (sometimes)…he hates those so he doesn’t like telling us anything because no spot is “OK” for the shots. The Shotblocker came in the mail last week and we’ve been using it and he’s still crying at shots when we use it, but I think maybe it’s because it’s just something ELSE and he just doesn’t like it right now, but eventually, I think if we keep using it, he’ll see that the new thing…(the shotblocker) is OK and he’ll come around.

I’ve ordered a “Pirates chest” after some recommendations I’d read about surprises, etc., for CGM changes and my wife and I are totally on board with this. I got a nice big chest from eBay and we’re gonna pack it full with stuff he likes (trucks/trains especially.) If anyone has any “non carb” related snacks or other gifts that you think a 2 year old boy may like, let us know!

Thanks as always everyone…such a wonderful place here to talk with people who UNDERSTAND a D’s life. @tiaE, I’m going to watch that video now.

-H

[quote=“ClaudandDaye, post:18, topic:55268, full:true”] Regarding your hubby - so sorry to hear about that. :frowning: If my wife and I weren’t in this battle together I don’t know how one or the other of us could do it alone…it’s tough even with 2 tbh.
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Thanks!

G-d willing, in another month or so, he will officially be my ex-husband. He moved out of our house almost one year ago exactly (much to the relief and, in all honesty, overall gleefulness, of my daughter and myself). His “early retirement” (read irresponsibility and lazyassedness) several years before my daughter’s diagnosis essentially built the coffin for our dying marriage, and the Type 1 served as the last nail in said coffin. If it wasn’t my daughter’s T1D, I’m sure it would have been something else… On the bright side, his complete and utter lack of knowledge of everything D-related made his request for joint custody a laughing matter.

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She is definitely where she belongs. You’re awesome, and sound like a fantastic mom.