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At what point is it a "severe" hypo?!

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.

Kei

Well-Known Member
Relationship to Diabetes
Parent of person with diabetes
F woke up at 1.2 this morning! 😱 That's the lowest she has ever been, but she didn't even feel hypo. Normally when she is at 3 or lower she feels shaky, wobbly and knows she is hypo.

We gave her glucose tablets and a digestive before her insulin, and her teacher is going to check her bloods at school this morning.

At what point does your child normally go VERY hypo (enough to use the glucogel?). We've never had to use the glucogel yet and hypos have, so far, been fairly rare for F, who tends to run high.
 
Hi Kei,

My own definition of a severe hypo is one that means I need help from others be it medical intervention or just my friends forcing me to eat surgary stuff or whatever. Personally I prefer to use glucogel alot of the time as opposed to tablets just because I find it's a bit easier to get down my neck quickly.

I've just had a lovely 2.4 mmol/L and felt a little off so I tested and got that magic number. Toast and glucose in me so I should be better in a little.

Tom
 
Hi Kei, I'd agree with Tom - it's bad if you can't deal with it yourself, although that's obviously very different when it is a child! 1.2 is very low, I think my lowest was 1.9 and I certainly knew it! If the reading didn't seem to correspond with how I was feeling I would be tempted to test again to make sure - the meters and test strips are reliable but aren't totally foolproof.

I think a lot depends on how quickly the levels are dropping - if very slowly, and particularly when sleeping, then your brain might be able to cope without distress but a quick drop would press the panic buttons. It's also possible that the 1.2 was the 'bottom' of the levels, and that it wouldn't have necessarily dropped any lower. I've occasionally had some hypos in the low 2.x's and not really felt any different, just happened to be testing before a meal.

I'm sure the other parents will be able to give you some better advice regarding children. Whatever the case, it's good that it doesn't happen often - hope it doesn't happen again for a long, long time🙂
 
for me i've only had one severe hypo that need help from ambulance/ a&e, and that was more due to the fact that I hadn't realised I was hypo initially, my blood sugar was below 2 at the time but can't remember exactly what it was. My lowest has been 1.3 and I was able to test and treat, although a little scary was fine.

I hope that you can find out what caused that hypo so that you can avoid it again. Might be worth testing in the night if you don't already to see what is happening.

I wouldn't ever want glucogel as I find it tastes horrible, what situation would you think that you would be using glucogel for?
 
F woke up at 1.2 this morning! 😱 That's the lowest she has ever been, but she didn't even feel hypo. Normally when she is at 3 or lower she feels shaky, wobbly and knows she is hypo.

We gave her glucose tablets and a digestive before her insulin, and her teacher is going to check her bloods at school this morning.

At what point does your child normally go VERY hypo (enough to use the glucogel?). We've never had to use the glucogel yet and hypos have, so far, been fairly rare for F, who tends to run high.

Hi Kei

I think you may have the wrong idea about glucogel. It can be used for any hypo. Hell I've even used it when Jessica has been 5.0 before PE to give her a quick boost up although that is not strictly speaking what it is for.

My daughter for some strange reason loves glucogel. However it does not work for her at all. I have once given her three tubes on the trott and it has done nothing at all, really it hasn't so we can't use it anymore. Have you actually tried it? I know a couple of people it doesn't work for or doesn't work quickly enough for.

I'm sorry but I've forgotten how old your child is. I'm a dingbat sometimes. My own personal recommendation which loads of people also do, is start to get your child to like diet coke, seriously ! Again he may be already drinking it. I started my daughter on diet coke at about 2 years old (she was diabetic by then). You should have seen the looks people were giving me in MacDonalds but I knew that coke would one day save her life and believe me it has a couple of times.

Coke (full sugar) or lucozade are the best hypo remedies. They are as good as putting a glucose drip in a vein. If you stick to one of those (lucozade is better and quicker than coke but coke is damn fast) you will learn how much is needed to treat various levels of hypo. For example start with 15 carbs worth which is 150 ml coke and 100 ml lucozade. I know that for a hypo of about 3.5 Jessica only needs half the can of coke and only about 50 ml of lucozade. (you can buy small party sized 150 ml cans of coke down the mixer aisles in supermarkets).

Glucogel is only 10 carbs per tube which may not be enough for a bad hypo and I would class a bad hypo as anything under 2.6 mmol. In Gt Ormond Street Hospital, which in my book is the greatest hospital in the world for knowledge if a child is 2.6 or under the medical team run fast, I've seen it numerous times. Different hospitals have different cut offs ie 2.2, 2.6, 2.5, 2.9 but GOSH say 2.6 and that is what I go with.

The idea is that brain damage can potentially occur with a blood level at 2.6 and under staying at that for an average of 4 hours. Now that is an average number so there are cases when it has happened with levels higher than that and less time. That is a reason why diabetics have 4.0 mmol and under as hypo.

Glucometers are not brilliantly accurate down there either, so a reading of 3.0could actually be 2.5 or 3.5 !!!

You could try Glucotabs or dextrose tablets. If your child has those give a glass of water with them it makes them work quicker.

I have loads of other tips but I may just drone on and on boring everyone so I'll quit while I'm ahead.

Bear in mind that I'm only a parent, like you, I don't have diabetes so what I say is all very clinical, if you like, and only from my experience over the years of seeing my daughter and loads of other kiddies.

Hope I have helped a bit.🙂
 
I agree with Adrienne. Glucogel does absolutely nothing for me and tastes disgusting! I've tried it a few times and my husband has given me it before when I've been too low to sort myself out and all it's ever done is go all over the place and stick my hair to my face!

I would go for lucozade every time, or coke if lucozade wasn't to hand and I'd consider a severe hypo as one that I needed help sorting or one that took a long time to sort because my BS was extremely low and still dropping.

Allison x
 
Glucogel tastes disgusting

Once when both of us were semi-asleep, my partner tried to give me Glucogel (I think it was called Hypostop in those long ago days) - when I resisted, he tasted it, and agreeing that it tasted disgusting, unwrapped a couple of sweets I kept on the windowsill. he never tried again! I'd had a couple of tubes for years, but never used them, and then disposed of them when they went out of date and never got any more. Never discovered if Glucogel would raise my blood sugar...
 
I think that for a child severe is all hypos as they all need help with them. Plus they can keep dropping while dithering around getting something.

However I would obviously move faster for anything under 3.5 than a high 3 and even quicker for anything under 3.

🙂
 
my son normally gets really bad moods the minute he's low
when he starts to answer me back and slams doors i say get ur meter
last night i asked him about five times to do a check he was starting to fall asleep so i di his check and he was 2.4 i think so three wine gums and within 5 mins back to his self again thats another grey hair for me then
 
Urgh! I jinxed it! Having said that she had never used the Glucogel, F has now used 3 tubes of it in the last 2 days, plus a tube of Hypofit, several packets of dextrose tablets, some flat lemonade and a few cartons of orange juice!

She got vomiting and diarrhoea on Wednesday night, so we've had two nights of checking/giving sugary stuff. She's starting to eat properly again now, thank goodness and seems to be getting better.

Thank you for all your replies! I think our DSN had probably suggested only using the Glucogel for very severe hypos because of the bad taste. I'd never have got her to use it normally, but when she was half-asleep in the night and her reading was 2.2, it was the only thing I could get into her. She pulled some hideous faces though!!!! 🙄
 
Wow what a few days. I hope she is on the mend. I use coke at night with a straw poked in Jessica's mouth and she drinks it and doesn't even wake up.

Just one thing lots of people I know have decided that fizzy is better than flat lemonade or coke. Something about the bubbles that makes it work quicker.
 
Just one thing lots of people I know have decided that fizzy is better than flat lemonade or coke. Something about the bubbles that makes it work quicker.

F hates fizzy drinks! I normally use orange juice if she's hypo, but with diarrhoea I didn't think orange juice was a great idea! 🙄 😉
 
F hates fizzy drinks! I normally use orange juice if she's hypo, but with diarrhoea I didn't think orange juice was a great idea! 🙄 😉

Hee hee yep you are right about the orange juice then. Lots of kids don't like fizzy drinks. I guess because Jessica has always been diabetes since 5 weeks old then I knew that coke or lucozade would be needed so I started her from a young age on diet coke. I tell you the looks I had but stuff it. It worked.

One friend has a real problem treating hypos. Her young daughter will only have those pre packed tubs of peaches in syrup so she has to use that. Basically you use what you can get in as quickly as possible. 😉
 
Hi,
My little boy is now 2and 1/2 and has been diagnosed for a year. He has been totally unresponsive though still able to swallow at 2.4 - this came on him very suddenly and the only thing i could get into him was glucogel so now i never go anywhere without it. I have tasted it and its pretty vile but he doesn't seem to object. He has also been quite low in the mornings with little signs so i think it does make a big difference how quickly it comes on - his worst hypos have always been out of nowhere during the day.
Last night I checked him at around midnight and he was 5.9 - this is never enough to see him to morning so i gave him a 5g biscuit expecting him to be around:confused: 8-9 in the morning but he was 15.4?? Does anyone have any thoughts - could this mean he has hypo'd and had an overswing? He has been a bit allover the place lately and nothing seems to be making much sense.
 
Hi,
My little boy is now 2and 1/2 and has been diagnosed for a year. He has been totally unresponsive though still able to swallow at 2.4 - this came on him very suddenly and the only thing i could get into him was glucogel so now i never go anywhere without it. I have tasted it and its pretty vile but he doesn't seem to object. He has also been quite low in the mornings with little signs so i think it does make a big difference how quickly it comes on - his worst hypos have always been out of nowhere during the day.
Last night I checked him at around midnight and he was 5.9 - this is never enough to see him to morning so i gave him a 5g biscuit expecting him to be around:confused: 8-9 in the morning but he was 15.4?? Does anyone have any thoughts - could this mean he has hypo'd and had an overswing? He has been a bit allover the place lately and nothing seems to be making much sense.

Hiya

You could be right. He may well have hypoed and this could be the natural rebound along with a bit of dawn phenomenen as well. Did he do anything a bit more energetic within the 36 hour period before hand, even mentally more demanding.

Unfortunately diabetes in really young ones is so hard.

Have you tried him with diet coke. I know it goes against the grain, but it would be a really good idea to start him getting used the fizzy drinks now, even a sip at a time. You can get 7Up Free or Orangina light, and slip in the odd diet coke. It will be so much quicker to get him up from hypos with full sugar coke or Lucozade when he is a little older. Don't get me wrong it would be easier now but unless your son is highly unusual it is very rare that little ones like these fizzy drinks which is why its good to get them used to it now.

Do you test him overnight? What regime is he on? Most children do not wake up when hypo at night. Lots of DSN's will tell you no need to test overnight but my reasoning is that unless they can 100% guarantee me that my daughter will be safe overnight then I test. Between 2 and 3 am is a good time to test. If you are unsure of what is going on then spend a week testing. I knew that if my daughter was 10.0 at midnight I didn't need to test at 2 am so long as she had not done any extra activity during the day. If she was under 10.0 I always got up.
 
Hi,
My little boy is now 2and 1/2 and has been diagnosed for a year. He has been totally unresponsive though still able to swallow at 2.4 - this came on him very suddenly and the only thing i could get into him was glucogel so now i never go anywhere without it. I have tasted it and its pretty vile but he doesn't seem to object. He has also been quite low in the mornings with little signs so i think it does make a big difference how quickly it comes on - his worst hypos have always been out of nowhere during the day.
Last night I checked him at around midnight and he was 5.9 - this is never enough to see him to morning so i gave him a 5g biscuit expecting him to be around:confused: 8-9 in the morning but he was 15.4?? Does anyone have any thoughts - could this mean he has hypo'd and had an overswing? He has been a bit allover the place lately and nothing seems to be making much sense.

does sound like hes gone low and come back up again what was he before bed
if my son was 5.9 before bed would need at least 10g of carbs or maybe a bit more
 
Adrienne - re flat vs fizzy drinks. I think you're right. It's the fact it's carbonated. That would make sense, since things like champagne (obviously extremely carbonated) get you drunk faster. Don't hold me to this though, since I haven't researched it or anything! 🙂
 
Hi,
My little boy is now 2and 1/2 and has been diagnosed for a year. He has been totally unresponsive though still able to swallow at 2.4 - this came on him very suddenly and the only thing i could get into him was glucogel so now i never go anywhere without it. I have tasted it and its pretty vile but he doesn't seem to object. He has also been quite low in the mornings with little signs so i think it does make a big difference how quickly it comes on - his worst hypos have always been out of nowhere during the day.
Last night I checked him at around midnight and he was 5.9 - this is never enough to see him to morning so i gave him a 5g biscuit expecting him to be around:confused: 8-9 in the morning but he was 15.4?? Does anyone have any thoughts - could this mean he has hypo'd and had an overswing? He has been a bit allover the place lately and nothing seems to be making much sense.

Hi there

Just joining in here -- agree with everything Adrienne has to say, though as yet we have been unable to get our son to do fizzy drinks...he's older, and has never liked them. He has also been diagnosed about a year.

One thing about biscuits though: this may seem silly, but we have had several occasions of a very small biscuit at night (8g) seeming to cause a weird high number in the morning....Like your experience, this is from 6mmols or so at bedtime. We are so convinced that some biscuits -- McVitties choc digestive, to be exact! -- cause this, that we no longer buy or use them for free carb. Other biscuits seem fine for this use.

re rebounding from night hypo: while anecdotally this seems to happen, it has not been demonstrated in test conditions. It makes sense in theory the body would catch itself in the event of a real crash, kick out glucose, then everything would rise -- but a) if it happens, it would seem to happen very rarely (eg if it's a pattern, it's not rebound) and b) like everyone says, we can't depend on the body doing this if there's a hypo at night. Certainly in our experience if there is a high waking number, rebound will be one of the things consultants want tested (eg a 3am test), but it is thought to be unlikely in the larger scheme of things -- CGMs have not been able to demonstrate it, though anecdotally people feel it's happened. It would have to happen though in the case of a severe low -- and the person would likely feel really quite rough the next day?

If it's not the biscuits (which I agree it shouldn't really be!), then dawn phenomenon and/or a spluttering pancreas may be the culprits...

Diabetes. Nightmare.
 
thanks for the input guys,
last few nights have been a bit more stable. Adrienne he's on twice daily levemir and 3-4 times daily novorapide. someone suggested giving him his night time levemir earlier so it peaks during the night but he's i fear whatever we do it solves one problem and creates another! Feeling particularly disheartened as we've been waiting for the last 3 months for referral to another hospital to start insulin pump therapy and having initially been told he was a great candidate and totally qualified the other hospital, who we do still fall into the catchment area, is refusing to accept the referral and wont even consider putting him on a waiting list for a pump as they have enough of their own patients on the list!! I know a pump isn't all rosy but with his increasingly erratic results combined with a growing aversion to injections I really hoped things could be better. Seems not.:(
 
thanks for the input guys,
last few nights have been a bit more stable. Adrienne he's on twice daily levemir and 3-4 times daily novorapide. someone suggested giving him his night time levemir earlier so it peaks during the night but he's i fear whatever we do it solves one problem and creates another! Feeling particularly disheartened as we've been waiting for the last 3 months for referral to another hospital to start insulin pump therapy and having initially been told he was a great candidate and totally qualified the other hospital, who we do still fall into the catchment area, is refusing to accept the referral and wont even consider putting him on a waiting list for a pump as they have enough of their own patients on the list!! I know a pump isn't all rosy but with his increasingly erratic results combined with a growing aversion to injections I really hoped things could be better. Seems not.:(

Also can I ask what would you say was a good hba1c result for young kids - anyone any idea, and whats too high??
 
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