I’m looking for some insight from you all. Today I tested my 3 year old daughter’s blood sugar while at our Mommy and Me class because it was snack time, which I make her lunch time since it’s at 11. It was over 250 which meant that I would have needed to give her some Novolog with her lunch. I had forgotten syringes so we just headed home to have lunch. It was about a half hour later when we were home and ready for lunch so I tested her again, prepared to have another high reading and give her a shot. It was 175. Has anyone else experienced such a drastic drop within a half hour? She had just finished running around the gym and playing a bit (although not playing so hard she was out of breath and/or sweaty) when I tested her the first time. It seems kind of odd to me and worries me a bit. But, then again, what doesn’t worry me these days?
I had a pretty similar situation last night. Son was elevated at dinner time (252) and required a correction. Knowing that he was tagging along to his big brother’s basketball practice, I intentionally withheld a portion of his correction dose. He played as he usually did and managed to drop to the mid-eighties about an hour later. This was after dinner as well. I think the little ones playing can really bring their BG down faster than we think.
I have a high energy, physically active 6 year old daughter with diabetes. When she’s exercising (either organized sports or just running around at the playground) we see one of two things: Her blood sugar drops during exercise and she’s low (60-80) immediately after OR Her blood sugar spikes (300+) at the end of exercise and then tanks over the course of the next hour. Yesterday she was 120 before her capoeira class, 300 immediately after, and 150 an hour after. It’s happened enough that I knew not to give her insulin at the 300 measurement–but to wait and check again in 30-60 minutes.
At a lecture on diabetes and exercise I attended recently, a doc explained that in addition to the physical exertion of exercise, BG will also be impacted by the emotional aspect – if they’re nervous, requiring a lot of focus, or even just having a really great and happy time – all this can impact BG to the high side.
So we’ve learned not to react to quickly to a high after exercise.
It could be due to her honeymooning, exercise and play or a combination of both. Willow just last night dropped from 393 to 56 in an hour while dancing. ( I reduced her basal by 50% and did 40% less than the recommended bolus) and she still dropped that drastically! needless to say she had to sit out the remainder of dance. And we still have some tweaking to do for activity time.
Before pumping I remember that often if the nurse from school called to tell me a high BG that I wanted to come in a treat - by the time I got there - she would have dropped either enough to where i did not need to give any humalog - or enough that the number were not nearly as worrisome.
Thanks so much for your replies! I’m glad to hear that this seems to just be par for the course. I’ll keep my eye on her blood glucose patterns in terms of exercise. Most of the time she’s low going into snack time at M and M which is why I was caught unprepared this time. She’s usually a bit high after her karate class, though. Thanks again!
New wrinkle: DD woke up from nap today at 528. Yes, you read that right: 528. I about fainted and tested her again: 485. NOTHING was amiss in terms of doseage, carbs, etc. so I have NO idea how she got up that high. She did exercise a lot from 10-11 ish but it was 3pm when she tested so high! Is it possible that it was delayed rise from exercise? I expected her to drop from exercise but she seems to tend to rise instead of drop…
I ended up just having her eat dinner a half hour early and using her regular dinner scale for her shot. She was 298 by then. That just wigs me out because she hasn’t tested that high since she was in the hospital. Anyone else experience this? Seems like her bs is getting harder to manage… Can I expect that I will just be on my toes for the rest of her life until she’s able to care for herself? (I’m thinking “yes”).
You will find that kids are very tough to manage and they almost never follow a discernible pattern. I see that these are wild swings, and the exercise factors in a tough way. two things need mentioned. You are not at fault for these wild swings, Stuff happens, and the cause and effect cannot always be known. As her mom you have to do the best you can, no one can ask more.
My niece disconnects for gym; makes sure blood sugar is at least 180. She will drop a hundred points in those 45 minutes. You need to plan for each activity, playing in the yard, bike riding, by the half hour or hour and give extra carbs for them. If a child is active in gym, I would not give a full correction as insulin becomes much stronger with exercise. She must have been more active than you thought!
your meter can be off by 20%, so at 250, that could mean if you retested her her # could be 200 or even 300…it could of been something on her finger or yours on the first reading. I have found my daughters numbers will drop or raise quite fast within less then 1 hour. Anything goes…
That is a huge, worrisome drop. We disconnect for dance, gym, etc. and make sure her blood sugar is at least 180 before the exercise, plus some coverage for active insulin. I would see if this is the norm; if so, I would disconnect from the pump for exercise if it is only one hour.
Gasp! Yes, you will be on your toes with that one! Never had experience with a child so young, but I do know there are a few “golden” years before puberty when they are supposed to be more stable and easier to manage.
We have had experiences like that with our 2 year old son. He always seemed to go high after playing hard and running around. I could never understand when the docs would tell me to give him uncovered snacks or lower covered snacks before he would play so he didn’t go low, but I never did because he would always go high. I do remember reading that if their BG is already high before exercising it can just go even higher. And it was suggested to wait until it was in a more normal range before beginning. For so long his numbers were all over the place and he was often high to begin with. But how do you tell a 1-2 year old he can’t run around and play and he has to rest for a bit! Yeah right! It has been tough and Rory throws a number in the 500s on occasion. I do have to say it hasn’t happened for some time now since we switched to the pump. And we don’t see as many severe lows either. He has been as low as 32 and as high as 590 at different times when we were still using shots. After a lot of adjusting he is now in a much better range and we don’t see numbers like that. I know what you are going through. Have you thought about or have the docs mentioned switching to a pump?
The nurse at our last endo appt. mentioned that they usually don’t recommend pump for at least a year. Insurance will also be an issue she said. Unless we’re non-compliant. Go figure.
It’s weird, though, because my daughter was at a birthday party at this great indoor playground on Sunday and played so hard she was sweaty for about an hour and went a little low and then normal that afternoon but exercised the other day that I posted and went super-high several hours after. I’m a patterns kinda person just in general…like to make sense out of things in my life. This one seems to elude me and, from what I’m reading from you all, it probably won’t make sense. Maybe they’ll move up the time line for a pump since we’re trying to hard to be compliant and her body just isn’t cooperating…
I struggled with how to tell my 3 year old that she had to rest for a bit at the indoor playground because I was afraid she was going to crash. She finally listened when I told her we had to rest or go home but it was hard. I’m glad I could let her go to the party and she had a fantastic time but, boy, was it work for me…oh well. It’s all part of the job description I guess.
Thanks, Rick. I’m not trying to be hard on myself but I definitely am a cause and effect kind of person. I appreciate those of you who have told me I may not always (or ever!) be able to connect an event/factor to a low/high. I need to know these things and I’m sure it will help me. It’s hard to keep as tight control as I’d like on her sugars while not poking the crap outta her poor little fingers…
the year thing…if you want a pump, get a pump…I had one dr say a year and one say we could get one right away…I just don’t know why they don’t have everyone start out with a pump, some areas of the states they do.
Oh, and the pattern thing…It drives me crazy because it makes no sence…so we just go day to day.
Yeah, I think I’m going to do some heavy-duty educating myself about pumping before our next appt. Don’t know what good it’s going to do me but it can’t hurt!
I have been going day to day but I started noticing too many highs and then there was the 500+ the other day that just threw me for a loop. But we did have a couple of fantastic days this week so I guess I should just focus on the positive and do the best I can with the rest!
Gotta go hit the hay so I won’t be destroyed tomorrow after the middle of the night check tonight…
I see your new to all this. you’ll always be “learning”. There’s always advise out there for you and you just need to do what you feel is right. after 1 1/2 yrs for us, we’re happy when we get a few good days a week too. It’s hard when they are growing at this age, #'s are always changing.
Now to educate yourself about pumps…everyone has their side…good and bad…I would say to contact the company, have a rep come to your house, and let them show you what they have and what they can do. they even send some nice info to you. We even got to wear one for 24hrs.
I had a night when my daughter went ove 600!!! I gave her a shot (she’s on a pump) to bring her #'s down, then found that her port wasn’t on tight.
The next step is for us to to the CGM, which is harder to get from insurances. Also check with your insurance and see what brands they cover, and if they don’t cover one you want, request it. The more people request a product the insurance company will look at covering it. Or work with you dr, they can recomend a pump is needed, or check with your local JDRF, they have done alot for me.
Thank you for the advice! These are the things I need to know. I’ve started reading “Pumping Insulin” but have been taking a leisurely pace since I didn’t think we could really push the issue for a year. But I will be picking up the pace so that I can bring it up at the next appt. At least then they can explain why they don’t do pumps for a year. Didn’t think to ask last time because the endo we see is at the ginormous Children’s Hospital and it was kinda busy. Lots to talk about since it was our first appt. since dx.
Does anyone do CGM before starting the pump? Or is there any point? I think it’d decrease my anxiety level if I had a more steady idea of what her bg was… But then there’s the insurance issue again.
We did a blind CGM through the dr’s office for 7 days, but she was already on the pump. We didn’t get the readings until the next week.
We had our pump in less then a year. They say you need to be ready to get a pump…that is you need to be able to count carbs…duh, isn’t that what we do already??? I even questioned this with the rep and dr…what’s the differance??? nothing…I find it easier to use the pump then the shots, because if she’s high all I have to do is “tell” the pump to give her insuline instead of giving her water or another shot. I contacted the pump company, had them send me the application, filled it out and they got the dr’s ok for me, but I also knew one dr had no problem with the pump, which was the name I used and not the other who wanted to wait 1yr. So in a sense I didn’t go through the dr’s office.
I read that book also and I thought it was very helpful. I think they say you have to wait on the pump to make sure you do get a handle on counting carbs and figuring the doses needed based on the BG, but I think it is important to look into it and continue to bring it up. They first told us they didn’t usually start pumps until around age 5 but yet I was finding all these people on here that were using them with their toddlers. So I brought it up again and then they got the process started with insurance. And with the CGM, they first said he was too young to do that now, but then I found out through here that you could do a 3 day session with it. So I brought it up again and now we will hopefully be getting that setup. I think by educating yourself and asking more questions it makes the docs feel more willing to move forward with different treatment options. The pump does have its own set of potential problems like you will read in the book, but I think anything does at this point. One thing I realized I have to really be on my toes about is the shipment of his supplies. We are setup for automatic shipment every 3 months and he was due for a new shipment at the first of this month. It usually arrives within a day or 2 so when it hadn’t arrived I checked the status online and it said Cancelled! I called to find out why, because I was only down to a couple set changes and would need it very soon. They said it was held because they were trying to send test strips and lancets which were denied by ins. because we get them through the pharmacy. I told them we don’t need those shipped through them and to remove them from the automatic order. The supplies arrived the next day but the catheter size was the bigger one, 17mm, and we were supposed to be using 13mm. So I had to call again and they overnighted us the right sets. The people are very nice and easy to work with but they never called to say the first shipment was cancelled and if I hadn’t been paying attention we may have run out of supplies. So anyway, the pump is a lot of work, but I think it is very worth it.
