Treating a low, newly diagnosed 11 year old t1

Hi all, my daughter had a low at school today just before lunch, 40 min, she treated with carbs 12 c 3 glucose tabs, then her prepunch glc 30 minutes later was 190, so we couldn’t really do a correction, I wonder if we can treat a low with a smaller amount if carbs next time?

I’ve had pretty decent results w/ 8-10. I’ve noticed that since I started doing that, that will cover it a lot of the time and I don’t go bonkers high afterwards. That’s great presence of mind for your daughter to handle that sort of hair raising situation though!

Helpful to learn more exactly what her correction ratio should be. It’s highly individual. Doesn’t take much for me. Just one gram of glucose raises me 10 pts. For bad lows, I use glucose & then eat a small amount of protein to keep BG level. Only way to learn how much she needs, is to test using 1 gram glucose as a starting point. Test after 15, 30 & 60 minutes. It can take as long as an hour to see the full effect.

Oh dear. Poor thing. You do not say if she is on insulin, but I suspect she is. I do not think she should have any less. The reason why she went so high after that was because the glucose has kicked in, but so has adrenilin (which gives us the energy to keep going) and adrenilin is a hormone that causes the body to throw out more glucose - a sort of self preservation mechanism. The body recognises that it is in starvation mode and needs the glucose but goes a bit too far. It will usually go back down and even she might go hypo again because there is still insulin or other blood glucose lowering medication in her system and it is still working. Just because she or any of us take glucose or other form of sugar does not mean that the insulin stops working. This is one reason why, straight after a hypo you need to eat some kind of slow release carbs - bread, pasta, potatoes etc to try to keep the second drop steady. I think personally, that after I have a low (and I have bad ones) I would like to be a bit high for a while and know that it will go down again without extra insulin.

Hypos are just as much an emergency as highs so you should not stint on the treatment just because you do not want a high after. It is the nature of the beast.

I hope she is ok now and that this is not a regular occurrence!
The fact that we are throwing out adrenilin and we often get a high after a low bears out the theory that when we are stressed we can also be high.

She is subject to lows during this first three month period while her glucose level is reducing, so be ready for more lows. Lower the basal. Her activity at school may be higher, too. Check with your CDE or doc as to whether one or two units.
The amount of carbs to give will be weight related. Do a test when she hasn’t had food or short acting insulin and test 3x over an hour.
The problem with giving TOO FEW carbs is that her low may be on its way down further than she tests. And with activity at school, that may be happening.
I think she did marvelously with 3 glucose tablets. I also think not correcting at 190 was the right thing to do.
Now as to the 190 not being ABLE to be corrected, that too depends on what 1 unit of insulin does to her and how much activity she was going to be doing next. It too can be tested. But it takes 3 hours of not eating to do it. Even if 1 unit takes her down 90, that’s to 100.
You’re thinking well and she’d doing right! Keep up the good work!
Sorry. I’m always long winded.

It sounds like she did the right thing to me, but I don’t know how big she is. The amount of carbs you use to treat a lot is tied to weight. As an adult, I (am supposed to) follow the 15/15 rule - 15g carbs, wait 15 minutes. Easier said than done.

Is she on the pump? If she was, she could have worked in the correction when she bolused for lunch. At least, that’s what I would have done. But it all depends on her insulin sensitivity factor. That’s why I like the pump - because the ISF is programmed in there and you can bolus very small correction amounts.

My son’s doctor told us that 1 glucose tablet (4 grams of carbs) will raise his blood sugar appox. 20 points. So if my son’s blood sugar is 59 then we would have him eat 3 glucose tabs and that should raise his blood sugar up to 119.

Each person may react differently, so you will have to make sure you log everything so that you can keep watch of how she reacts.

Good luck!