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glucose in urine-possible causes?

(158 Posts)
ariane5 Mon 31-Dec-12 13:51:55

Dd (3) has been unwell lately and urine samples have shown glucose over the past week ranging from a trace to +++

What could cause this? She has been poorly a lot recently with ear/throat infections and has been very tired and had an itchy rash.

Only one of the samples showed wbc and she was treated for a suspected uti but this morning her sample was showing trace of glucose again.her diet is not high in sugar.

What could cause this?

ariane5 Thu 10-Jan-13 22:54:58

50 ml not l! Thatd explain a rise if it was litres!!

OxyMoron Thu 10-Jan-13 23:41:09

The more info you have about her bG levels and what she eats, the easier it will be to figure out what her insulin to carb ratio should be at meal times (ie. How many carbs she can eat per unit of insulin given). It took us a few weeks to (a) get the basal as good as we could (wasn't that good as we were also on lantus and had the problem of no half units) and (b) get a reasonable estimate of her insulin to carb ratio. She was all over the place in those weeks (often near 30 after a meal, plus hypos daily) and I think that's common. It just takes a while to get the doses anywhere near right, and after that it's finer-tuning and adjusting as they grow.

ariane5 Fri 11-Jan-13 17:38:16

Really bad night again last night dd had 2 hypos, the consultant has said no basal inj at all untill tues when they see her at hospital.

Dh has just left me for half an hour on my own with her and ds2 so iam sitting here holding ds and watching dd (she's asleep) while he takes our older 2 to go to get something for dinner, I'm terrified but dh really wants to go back to work and wants me to try and cope alone (I want him to give up as other dcs have health issues and I'm not sure I can cope on my own). I am trying but its hard.
Really hope tonight is better I find hypos so frightening

ariane5 Fri 11-Jan-13 20:21:42

I think Iam doing something wrong on CWD login I put in my email and password but I can't seem to get onto it or post anything am I doing it wrong or missing something really obvious?

LaurenBacall Fri 11-Jan-13 20:26:12

No basal insulin at all until Tuesday? Gosh, I've never heard of that before. If she starts to run very high, please do contact them over the weekend. Do you have contact details for the DSN or is it the children's ward you ring? Maybe it will help. She is probably honeymooning at the moment which means her own pancreas is still producing some insulin - that could be what's sending her low overnight. But you never got a chance to try the Levemir, did you? Weren't you to start that today? Were you giving the Lantus at night or in the morning?

I don't know your other circumstances but you will be nervous the first few days you spend alone when your DH goes back to work. This is still so new and raw and probably not the best time to be making monumental decisions like that. Your DD is safe with you, her Mum, I promise!

Please come and introduce yourself on CWD. It's a closed list and there will be many less people reading there than here! It's not scary but it is a place where you will get good support to help you deal with these feelings and fears. We've all been there and the CWD ladies will help allay your fears. And I bet they'll have some worthwhile suggestions about the overnight hypos because they've been there too.

LaurenBacall Fri 11-Jan-13 20:28:09

Oh cross post? Gosh, I don't know. I have the emails through my hotmail account and read it from there. Where are you trying to log into? Hopefully they email list - there's a discussion board too I think but heaps less traffic. Lt me know and I'll try to help.

OxyMoron Fri 11-Jan-13 20:28:59

ariane, pm me the email address you want to use for cwd (might be best to open a new account just for cwd, there is a lot of traffic), I can ask one of the admins to manually add you.

LaurenBacall Fri 11-Jan-13 20:31:01

Are you using the email address on this link?

ariane5 Fri 11-Jan-13 20:44:47

I think I know what I've been doing wrong ! On phone at moment but when I can get on computer I will have a try to post on cwd.

We were meant to collect the levemir today but nurse phoned and said nothing till tues and they will see dd then, I was worried she would start getting v high but hopefully she won't she has been really really low from about 3am every morning.
The nurse also changed dd to a glucomen monitor that does ketones as well.

ariane5 Fri 11-Jan-13 20:47:07

Lantus was being given at night around 10pm I forgot to add

ariane5 Fri 11-Jan-13 20:52:16

Jmf294-I cannot seem to pm whilst on my phone but once I have a pm I can reply, would really like to meet up if possible at some point if you still don't mind just pm and I can reply to you.

kpandthesunshineband2 Sat 12-Jan-13 00:18:49

Sounds odd not having any basal. Make sure you check for ketones if glucose levels start to rise over weekend. Thought you would still need some basal!

If it is impossible to get low enough dose of lantus/levemir without causing hypos then this is where a pump would be much better as can give smaller doses & have different basal levels at different times of day.

paddyclamp Sat 12-Jan-13 19:59:14

I've always been told NEVER to stop my Lantus (basal) even if i'm ill and not eating confused

ariane5 Sat 12-Jan-13 21:07:47

Ok, Iam worried now WHY would they stop dd basal injection ? Should I just start it again? They said to not do it until they see her on tues in clinic?

I joined cwd but can't get on computer only on my phone so can't put anything on there and ds2 still up so I'm so busy.
I'm so worried dd had a hypo last night again I don't understand I thought without the basal she would be higher today but actually she has had lower bg.the nurse kept mentioning honeymooning is this something to do with that?

What do I do re basal inj ? I am scared something will be wrong now I don't understand what on earth the hospital are doing. Dh spoke to them on phone not me maybe I should try to phone the ward?

paddyclamp Sat 12-Jan-13 22:26:53

No offence OP but your DD's medical team don't seem to know whether they're coming or going!!! I can't believe how little you seem to be receiving in the way of information and support...when i was diagnosed i was in hosp for 2 weeks!! i know that's no longer the case but it gives you an idea of the scale of information we had to get used to!

The hypos will almost certainly be due to the honeymoon period where her pancreas starts producing some of its own insulin before it finally gives up the ghost - this can last for about 6 months

How much basal insulin was she put on before they asked you to stop it?

ariane5 Sat 12-Jan-13 22:51:00

Initially in hosp 3 units at night they reduced it to 2 after couple of days and then down to 1 unit as she was still having a lot of hypos.last night was 14t night with no basal and she still had hypo during night and bg was quite low today.

Iam frustrated at the lack of info and support from hosp DSN was nice and helpful when we met her but the whole period over xmas and new year and the week in hosp nobody told us much and we got a lot of conflicting advice.

paddyclamp Sat 12-Jan-13 23:06:45

Is she then having novorapid with meals? Have they gone through carb counting?

Honestly this is insane!! .... I know how little friends and colleagues know about type 1 and how i have to explain it to them, so how the heck they expect a parent to look after their child with so little information i'll never know!!!! .... How low has she been? I think i would turn up at the hosp and demand some answers!

ariane5 Sat 12-Jan-13 23:23:41

Yes novorapid 1 unit at mealtimes.last night hypo she was 3.8 previous night 2.7 and 2.8 night before that. They had told us to stop 3am check but I couldn't just in case iam glad I ignored them.

I feel exhausted by all this its ridiculous I have ordered books to read but I am not a doctor a lot of it is confusing.
No mention of carb counting yet we are just giving her her 'normal' meals trying (and hoping) that we are givinng her the right things.

OxyMoron Sat 12-Jan-13 23:31:22

Honeymooning is the only reason I can think of for stopping basal insulin. The honeymoon is the period after diagnosis, once insulin has been started , where the pancreas reactivates a bit and uses its remaining beta cells. It means the child needs much less insulin than they do later one when more beta cells have died off. I have never dealt with it as my dd had no honeymoon period.
I would keep a close eye on her bG and ketone levels, and don't stop the night checks if she's hypoing at night.
Do you have out of hours numbers to contact your team when you need to ask questions?

ariane5 Sat 12-Jan-13 23:48:42

We have a number for the childrens ward if we need to speak to a doctor.
I have been surprised how dd bg has been quite low today I assumed with no basal inj it would creep up but it has been low (well low for dd around 8-12 most of day with a couple of drops to 4 or5). Usually we have highs in the afternoon of anything up to 18 (which makes her suddenly fall asleep).

I am finding it all confusing but everytime I get a spare min (not often!) I've tried to read some bits from the books I've got (that were recommended on here).

paddyclamp Sun 13-Jan-13 00:15:11

Def don't stop the night checks...i test my blood about 10 times a day so you can never do too much testing! What the heck are they doing telling a newly diagnosed parent to test less?!?

I know it's different for me because i'm an adult but your DD seems to be on very little insulin so she must be in a honeymoon, or maybe it's more complicated because of the other medical problems she has? ..... I take 14 units of basal, and 1 unit of novorapid for 10g of carbohydrate, so eg at breakfast i have 7 units.

Things is, all the books and information from us guys isn't the same as proper medical advice for someone who knows your are being treated appallingly IMO...get on the blower in the morning and demand a review...don't worry too much tonight as nothing drastic will happen now that she's had some insulin but you shouldn't be going through this alone!!

ariane5 Sun 13-Jan-13 00:45:33

From what I know dds other medical problem (ehlers danlos syndrome) shouldn't affect blood sugar/diabetes in any way at all.It is a disorder of the connective tissue so she has problems like pain, fatigue, dislocations, constipation and a hernia. It has never had an effect on any medication before and I made sure all tje doctors we saw in hosp knew she had eds and they didn't mention a link.

She is 3 and weighs 13.6kg so not sure if weight/age affects insulin dose?

Iam just confused and worried and not having had proper advice has made me more anxious-I knew that day in hosp when dd had a hypo and the nurse wanted to give dd insulin then lunch that things would be difficult.

OxyMoron Sun 13-Jan-13 00:59:15

Yes, weight affects insulin dose. The smaller you are the less you need in general, but lots of other factors affect it too (e.g. growth hormone activity means you need more insulin).
I would seriously consider asking to be transferred to a better team. There have been recommendations on this thread. Even though we parted from our original team, they were good at the beginning. We had a 10 day stay in hospital (not usual, but my dd was extremely sick at diagnosis), a structured education process, frequent home visits initially, and a full list of contact numbers including out of hours care. You could ring the main switchboard at your hospital and ask for the on-call paediatric endocrinology registrar, or the on-call paediatric registrar. I'd also consider talking to PALS about the lack of support.

Hope you have a reasonable night.

LaurenBacall Sun 13-Jan-13 20:45:54

Ariane, I second what Paddy said - don't stop the night checks. Always do them, even when DD is stable - you will catch highs and lows. Many of us consider it dangerous not to test at night.

Do you give a flat 1u of Novorapid with each meal? Have they taught you anything about carb counting? Even when DS was first diagnosed we did rough carb counting - he was also 3 and on a different regime but we had to match carbs to insulin which was awful. Have you done any BGs two hours after a meal? The number then would give you an indication as to whether or not the 1u is working but truly you'll never know unless you carb count.

The more I read the more I thnk referral to another hospital - immediately!!

Hope today was better.

ariane5 Sun 13-Jan-13 22:37:14

Yes 1 unit with each meal regardless of what she is having in fact we have had no real advice about food except one leaflet from hosp about snacks.

I got the carbs+cals book and from what I can see dd is not having enough insulin for the amount she eats (I may be wrong) she has had a lot of hypos 2 in the night and 2 this afternoon she gets quite low v quickly we have to give her juice then she's really high again(16).

We have done a food diary and a BG diary since being in hosp-bg on waking before meals and 2 hrs after before bed and we check at 12 and 3am, at 12 bg usually quite high but it starts to plummet around 3am and sometime after that dd has hypos around 2.5 so after 3am we know we have to keep checking her.we tried waking her when it got to 5.0 to give her a snack but she still had a hypo an hour or so later.

I don't want to adjust her insulin myself based on what she eats as I would worry about overdosing her.I am really confused though as things like 1 potato waffle in the book was 12g carbs and it said 1u per 10g carbs so if dd has a dinner of 1 potato waffle, vegetables and 2 fish fingers plus a bowl of plain soya yog and strawberries (that's the sort of quantity she has) then surely her 1u will not be nearly enough to deal with the meal she's just eaten??? Or am I getting it wrong (Iam v bad at maths and similar things).

SO confused by it all

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