A Hypo Mystery

I'm going to need to restock the juice box supply.

So many juice boxes this week….

If Luke is coming up on a site change and it’s close to bedtime, he usually asks me to wait until he’s asleep. No problem. I can pull off his old infusion set and place his new one and he doesn’t even bat an eye.

So last Wednesday night that’s what I did. I also took the liberty to place his new set on a little used place on his body, his upper thigh, for the sake of good rotation.

His BG the next morning was 48, which sometimes happens after a site change, so he downed a juice box to start his day. Pre-lunch BG was 270, he ate about a cup of ziti noodles with red sauce, we bolused for a small BG correction and 45 grams of carbohydrate, and I sent him off to school. An hour later he was 47.

What the….what?

The next day he had nearly the same scenario at school, plus a couple more low-40’s hypos at home. So I pulled his thigh site that night and placed a new one on the back of his arm, the old tried-and-true standby.

Incidentally, both days he was uncharacteristically irritable and aggressive at school and found himself in time out several times. He typically gets spacey and whiny when he’s low, but he doesn’t usually have so much trouble controlling his behavior.

My (loose) theory is that the thigh site was too close to the muscle (this skinny little boy is pretty short on adipose tissue) which caused a too-rapid uptake of his meal boluses. And then the resulting quick drop in his blood glucose caused extra irritability and crazy-boy behavior.

Either that or his pancreas has rebooted.

(Kidding, kidding….)

5 thoughts on “A Hypo Mystery

  1. Ryan Cannon

    I agree with you diabetes is at times very hard to determine what made our blood sugar become high or low. This is very frustrating especially when you feel like you have done everything right. In times like this I have found the only thing that helps me is to tell myself “tomorrow is a new day.” Of course this perspective most likely won’t help you son feel better about the lows. If the morning lows become frequent then I would check with your endocrinologist to see if the night time basal rates need to be adjusted downward. This is something I have to watch constantly because I am prone to morning lows due to a high metabolism, inconsistent absorption, frequent exercise, and a large appetite.

    The other things that is baffling about diabetes is how different each person’s experiences are. For example, I get zero absorption in muscle tissue. The only place I can get absorption is my upper rear where I do have some fat tissue. It hasn’t always been this way but after twelve years on the pump this is my current reality.

    1. Angela Major Post author

      Thanks for sharing your experience Ryan. If I’ve learned anything in the past few years it’s that diabetes is never the same, that’s for sure. I am definitely keeping any eye on basal rates, as well as ICR’s, but this kid’s always been a roller coaster. I’m hoping he’ll grow out of it….

      1. Zach

        Yeah everyday is something new with diabetes. I still have days where I have those mystery readings where I have no idea how I got that number. In recent months I have been trying super hard not to get the urge to over correct severe lows because then I end up high later on and then I just enter the yo-yo effect. Have you looked into Continous glucose monitors? My experience with the CGM has been amazing thus far. If I personally had to choose between having a pump or CGM I would always choose the CGM. Anyways, Hope all is going great with you and yours!

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