He is an amazing little boy. When he discovered me off crying in my room, he brought me our chihuahua because “dogs are really good for snuggling when you’re upset” and then got me a glass of ice water and sat with me.
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I wonder if it was delayed insulin delivery. also not sure if she’s going through puberty, but one of the founders, @Michel, used to mention super high rises followed by precipitous drops with puberty. But we sometimes have this as well and it’s always a mystery. Sometimes it clears up with a site change but sometimes not.
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She is in full-on puberty, eye-rolls included.
What might cause this?
I wonder if it might be. The leg muscles are very utilized muscles in our bodies for most people. And using a muscle will increase absorption if I understand from posts that @Eric has written in the past about exercise. If she had been active, could this have played a role? Maybe @Eric will chime in if he’s got a thought about this.
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I think it increases absorption rate, but not absorption amount?
Others are a better source on this than me, but in my experience with different pump sites, some areas will give me “more bang for the buck” with insulin than others. Some areas, especially active parts of the body, may help the insulin act much more efficiently and effectively than other parts of the body. I treat pump sites on my rear end differently than ones on my arm because they are so much more efficient than my arm sites. So my quantity of insulin used, mostly for boluses, can change a bit. But I do not see so much of a difference in site absorption as to cause a complete LOW on the Dexcom…just smaller post meal peaks and more dips…but nothing quite so severe as what you guys experienced.
Deferring to the experts now…
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Delayed insulin delivery could be caused by “pooling” of insulin at the absorption site, for instance if my son needs to deliver 14 units, we never use the pump alone. We will never give more than 10 units via the pump, anytime we do, it feels like the insulin never gets delivered in a timely fashion, and we end up with insulin delivery over an extended but unpredictable period.
So when he needs more than 10, we just use a syringe and inject it, and if he needs it quickly, he injects intra-muscularly.
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#3 - this is so good to know! I know it shouldn’t matter, but that enormous syringe that comes w the glucagon is DAUNTING and really scares me away from using it. Also great to know about microdosing it. Great info. Thank you! Jessica
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Sorry you went through that. The combination of fear and responsibility is rough, and the way you worked through it is truly commendable.
When very low (well below 40) I find that glucose no longer tastes sweet. It has a nasty metallic taste instead, and it requires an effort of conscious will to make myself eat it. So that could help explain her refusal to accept the glucose. As others mentioned, a microdose of glucagon with an insulin syringe could be a workaround with less fighting. Expensive, though, unless you have an older expired kit that you don’t mind using up. (It still works past the expiration date, so you can save the newer kit for an emergency where there’s a loss of consciousness.)
That’s something concrete that you can change. I’m still learning this the hard way for myself, albeit in a much less dramatic fashion. Last night I restarted the sensor when my BG had leveled off around 100 after dinner, and about 40 minutes later didn’t feel quite right, so took a fingerstick and was at 47. I’ve got to get into the habit of routinely checking my BG during the 2-hour warmup time. And I know this, but I didn’t bother. Or maybe better, I should start using the spike app (or xDrip+ for android folks) so that there’s BG information even during the warmup.
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Yes! Absolutely disgusting! For me, that metallic taste can last up to an hour after recovering, too. And I’d add that my own serious hypoglycemic event last week, also WELL below 40, left me really nauseous (and vomiting). I posted and have heard back from others that nausea can accompany lows. It may have also contributed to her strong aversion to the glucose. My family tried to give me orange juice, and I just couldn’t…
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That’s a really good idea. In this particular case, it wasn’t in warm-up and we are using xdrip+, but it was just too far away from her to pick up the signal. The range on the G6 is not good.
I just asked her and she said that it tastes really nasty. I had no idea!
I didn’t realize that it would work after the expiration date. We keep old ones for practice/training so we do have at least one old one around.
The moral of the story for me is don’t go without the cgm. So in your example, only charge one device at a time, so the other stays in radio range for safety.
Once you mix it there’s a very short shelf life, like 1 day, but if you have a few old ones around, why not practice a microdose or two some day when there is a low but not an emergency, just to see how it works. You could even have her little brother mix and give the microdose in this non-emergency case, under your close supervision, so that he’s already done it before in case he really needs that skill some time in the future. I bet the children would bond over that kind of experience.
Agreed. We had the same thought.
This is a fabulous idea.
Also you mentioned she wants a pump break – so she probably won’t mind the additional shot associated with the glucagon. For us, that’s the only reason we don’t routinely use the glucagon kits for mini-gluc on lows – he hates needle pricks.
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Yes, right! She mind the needle.