January 5, 2004
Insulin Pumps
Question from Burlington, Ontario, Canada:
My daughter is 8 years old. She has had Type 1 Diabetes for 2 1/2 years. She is still on rather low amounts of insulin, her hourly basal is 0.1 or 0.2 throughout the day. The other night, she was in the hot tub and came in to get changed for bed. Unfortunately, she forgot to put her pump back on. I found her pump the next morning at 7:30 a.m. She was still sleeping so I quickly tested her blood sugar and miraculously, she was only 9.3 mmol/L [167 mg/dl]. I then tested for ketones and there weren’t any. How could this be? She was off her pump for 11 hours with no ketones and blood sugar of 9.3. Is there an explanation for this or did she just have an angel on her shoulder that night?
Answer:
I like the angel answer but I suspect that she is still making a small amount of insulin. Since overnight food intake was quite low, as usual, therefore she did not need very much insulin and was able to make more or less what she needed. Not enough to keep her glucose levels normal but sufficient to not have ketones produced or to raise her BG levels extraordinarily high. You may want to do some overnight BG checks to be sure her usual overnight basal insulin doses are not too high and to be sure that there are not nocturnal hypoglycemia events going unnoticed.
SB
