advice-not eating

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hkk1970

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Hi, Harry is not eating much at the moment. His levels are fluctuating between hypo and 5-6. What advice would you give with him being on the pump. I have put him on a 20% basal for the time being. I worry when his levels are like this particularly through the night. Thanks Helen
 
Is he drinking? Can you top him up with OJ or Lucozade etc?
 
Hope he is ok ! I get like that quite often & sometimes dont want to eat. Love missing dinner at work when busy. I think you have done the right thing redusing basal. That is a good thing about a pump. 😉 Testing is the thing
 
Thanks for your replies. It's 1am and he has just been sick everywhere and levels increased to 16. So big correction and basal back to normal. It's just never-ending, 2nd time in 6weeks we have had this. So I assume low levels again for a few days like last time. Will I ever sleep again...Helen
 
So sorry to hear H is under the weather - winter classrooms are just a broiling soup of infection and lurgy aren't they! Hope he bounces back quickly, sounds like you are doing brilliantly managing his levels through the upheaval
 
Hope you manage to get some sleep. Hydration is a big thing in these times when being sick etc. Really good luck 😉
 
Oh dear poor Harry, I'm afraid at that age the tummy bugs just keep on coming :(

When he doesn't want to eat but his levels are low, try him with treats like sugary jelly or sugary ice lollies - these will get some carbs into him so you can bolus tiny amounts of insulin and keep the ketones away. And they also help keep him hydrated.

Hope he's better soon!
 
If he is ILL & not active Keep him away from carbs. Blood test will tell you where he is at. Good luck 🙂
 
HOBIE said:
If he is ILL & not active Keep him away from carbs. Blood test will tell you where he is at. Good luck 🙂
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This is incorrect advice - small children have very low basal needs so when they are not eating and bolusing for food they are more vulnerable to ketones. If his BG is low he DOES need carbs, so that small amounts of insulin can be bolused and ketones can be kept away.
 
Hi,thanks for your replies. We are having it very tough at the moment. He is sick daily and isn't keeping anything down. We had his worst hypo ever yesterday of 2.3 and he wouldn't have his hypo treatment. Me and my mum had to hold him down and force glycogen into his mouth. He just wouldn't come up and he kept going hypo. We ended up at the hospital to get checked out. Then his levels came back up and we came home. The bizarre thing is today he has eaten carbs and not needed any insulin. His levels have remained stable. Though he was sick again. Has anyone found this to be the case for them? The dsn thinks his basal is enough for his food at the moment but this is worrying me.
Helen
 
Meant Glucogel!!!
 
It's very difficult to judge, Helen. Perhaps most of the carbs he ate today didn't digest and end up as glucose in the bloodstream. Also, his liver could have released some stored glucose. One of my son's tummy bugs was so relentless he was vomiting every 30 minutes or so for a time, even bringing up water and saliva - we had a bag all packed ready to go to hospital, expecting untreatable hypos, when he actually rose a bit and stayed in the 8's - must have been stores from the liver released in response to stress hormones. All you can do is follow the numbers and react accordingly (so glad you've got the pump, so you can actually DO something - some of my son's tummy bugs were on twice-daily mixed insulin, oh God!). Just check BG and blood ketones frequently. If he is continuously hypo with ketones, you need to go to hospital. If he is high with ketones that don't respond to insulin, go to hospital. And if he is dehydrated I would also take him in (pinch up the skin on the back of his hand and let go, it should spring back if he is hydrated, but if not it will stay creased like an old person's skin). But hopefully you will be able to manage things at home and he will get better soon 🙂. You must be shattered too .....
 
Thank you red kite. You have reassured me regarding the absorption of the food. He has actually had half a small pizza tonight with no rise which I can't get my head round at all. Yes I am shattered but am prepared to keep getting up in the night to keep him safe.
Helen
 
Hi Helen, sorry little Harry isn't feeling so well and thus you are shattered as well :( Hope things improve soon.
The same old suggestions will come from me though.... Has the little chap been tested for Coeliac disease and Addison's disease?
 
Hope you and Harry had a bit better night Helen? His food absorption will be delayed for a couple of weeks even after the vomiting/diarrhoea has stopped, as his gut will be healing. His insulin needs will be lower for a while and you may find it works better to bolus after eating and to use square wave boluses instead of normal boluses until his appetite and digestion are back to rights. 🙂

Sue, it's standard as part of the annual tests for children to be checked for coeliac antibodies, but not Addison's. But I really don't think Helen needs to worry too much about those issues - Harry is 4 and at that age the d&v bugs come thick and fast unfortunately! I bet the whole class has had this bug. When my son was in Reception he had three tummy bugs in the space of 5 months, and I was totally p'd off with all the thoughtless parents who send their kids back to school before the "48 hours after last vomit" had elapsed. Especially since I also caught the 3rd one from him :(. As a consequence he is now slightly OCD about hand-washing, never drinks from a water fountain, never shares water bottles or sucks pen tops etc. Anything we can do to try not to catch these awful things!
 
With respect Red, the blood tests for coeliac are not accurate, hence why I asked.
I mentioned Addison's as well because I had the same symptoms I could eat to the cows came home and still be hypo. One day I consumed 500 carbs and had no insulin. Yes you have read it right 500 carbs 😱 I was also still hypo after that episode. Then a few days later I would be high and so it went on.
Age is no barrier to autoimmune conditions.
 
Hi, he has ben sick in the night again and levels dropping. Am on the phone to diabetes team regularly at the moment. They want him to keep drinking sugary drinks and biscuits to get his levels up but he is just refusing. I am fighting a constant battle, even though it's not an ideal choice, I wish they would have him in the hospital to monitor him. I don't know whether I can do this for another night. Thanks for your advice and support though. Helen
 
Poor little soul :(. Don't be afraid to take him in if you can't cope, whatever they are saying! It's awful trying to force a little one to eat and drink when they feel rotten. What worked for us was persuading him to take tiny sips of full sugar ribena through a straw, sugary ice lollies such as the fruit pastille ones, and small amounts of full sugar jelly. I used to make up a bowlful each day and then offer him a few teaspoons from time to time. If he fancies nibbling on something, a few dry Cheerios seem to be manageable. I'd avoid fatty things like pizza for a while until the vomiting comes to an end. I used to find Knorr chicken noodle packet soup quite good too - wouldn't normally have something like that but it helps replace some lost fluid and is savoury for a change from sweet liquids, plus there is a little carbs from the tiny noodles.

It's like torture for them isn't it? At least with a non-D child you can just let them be and not force food and drink on them.

Sue, I wasn't disagreeing that poor absorption of food can be a symptom of coeliac and Addison's, just that in this case Harry has an obvious cause for his hypos so don't need to look too far. If he was having these issues without a tummy bug then of course these other things should be considered. 🙂
 
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