Hi all,

My 4-yr-old's (dx 9 montha ago) bg tested at 45 this afternoon. I treated with a glucose tab (4 g carbs) and 1/5 C orange juice (5 carbs) so 9 carbs total. I rechecked her in 12 minutes and bg was 369. Then double checked with an alcohol swab and got 390! Then did a control test and control solution was 131.

Can anyone make sense of this? Is that even possible to go from 45-369 in 12 minutes? I'm questioning if she was even that low to begin with but don't know how it would have come up in the meter. ANy help or words of wisdom is appreciated. Thank you!

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I sorry to hear that.
My intuition would be that she was not that low to begin with. However, I think you made the right decision because it is better to correct a low and find out that it was not that low then to wait or recheck. I would suggest to bring it down slowly and check again in 15 minutes.
Make sure the glucose monitor is working. Also my experience is hat the alcohol swab tends to give a false high reading, but not so excessively high.

I've had just the opposite effect with alcohol swabs, producing false lows. Was she symptomatic at the time when she tested 45? Its all a learning experience, but my advice would be ditch the alcohol swabs and just use good old fashion soap and water. There is no need for alcohol and actually it dries the skin and can over time make testing more painful. My intuition too says she probably wasn't that low to begin with, just 9 months into a diagnosis, I think she'd be very shakey and symptomatic at a reading of 45. You might also pick up another inexpensive meter. A lot of stores like awl-mart with the Relion brand make very inexpensive meters and test strips, and just do a compare to see if they are giving you results a close range. I too find it really unlikely to go from 45 to near 400 in just 12 minutes with only 9 grams of carbs.

Her hands were definitely washed with soap and water prior to the bg checks. Thanks for all your insight!

An alcohol swab is a poor way of removing residual sugar. Sugar turns out to not dissolve in alcohol, but it does in water. If there was residual sugar on the fingertips, that could easily corrupt the test result. I have taken to washing my finger under test with mild (non glycerol) soad and water. Alcohol only makes sense to ward of infection, and I've never had an infection at a lance site. In fact, I've never heard anyone say they had an infection at a lance site.

I've never either in close to 30 years had an infection at a lance site, lol and I'm one of those bad people who change the lancet out like um once a year maybe, If I think about it.

Wow, I've never had a low error reading of that magnitude. What sort of meter is this? Unless it's like a "food on board" situation where she'd eaten something that didn't work quite as planned but it was pushing BG up or something like that, I would be very leery of the meter? It has got to be much harder to deal with on somebody else, who's four and may have problems reporting "I can tell I'm low because I'm zonked out of my gourd" or "I can tell I'm high because I feel slushy.

I've dropped from 350 to like 70 (long story, IV R insulin...) but even that would take more like 1/2 hour. I've never seen a rise that quick.

It's possible. Depending on the insulin on board and the sensitivity to what I am eating. I've had days where I've tested at 50, eaten 5 or 6 skittles and 6oz of juice and re-test 10 minutes later and find I'm at 275 and climbing.

It's hard enough as an adult to "feel" what kind of low or high I'm having and treat correctly. If it's an "oh crap, black out soon" type of low, I'll take care of it. But if it's a "hmm I don't feel low" I'll wait. Same with spikes, I hate to treat a food spike with too much insulin, but if it's been hours since I've eaten and taken insulin I'll start correcting.

My daughter is 4 years old too, but 3 years of diabetes ;-)
I have never seen such a fast "jump", I think the 45 was false (perhaps water diluted the sample?).
Otherwise your baby has still very good counter-responsive hormones and took herself out of the hypo (plus your carbs).
Which bg meter do you use ?

Great info, thx guys :) we have a Bayer contour next link meter btw. I know each body is so different but is there a general bg range wherein the counter-responsive hormones kick in to reverse lows?

A BG rise with sugar is definitely possible in 12 minutes. A drop of the same size with insulin is unlikely unless magnified by exercise.

Remember that glucose tabs are designed to be very rapidly absorbed (ie very high GI), and orange juice is also high GI. My daughter is 8, and 1 unit of insulin drops her BGL 16 mmol (288 mg/dL), this is equivalent (for her) to 15g carbs. So 9 g without insulin will raise her BG 9.6 mmol (172 mg/dL). It all depends on your 4 year old's ratios.

Alcohol - I agree, do not use. Soap and water is the best, and usually this is unnecessary unless they have been playing in the dirt or swimming in the sea.

Simon, thank you for sharing! My daughters isf is 1:300. It never occurred to me to reverse the number with carbs but that makes total sense. Lots to learn still!

With T1D, anything is possible. BUT, I would say it's probably more possible that her BG wasn't that low to begin with. It happens -- sometimes you just get a bad strip or something interferes with the reading. Did she have any "low" symptoms?

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