Blood sugar check and the bath

[Maddymom]

My 6 year old daughter was diagnosed Type 1 diabetes 9 days ago.  I am proud to say her blood sugar has been within range every time I have checked over past 5 days.  Except...  Her blood sugar has tested low all four times I tested either while she was in bath or just out.  She has tested between 57 and 68.  Is anyone aware of "wrinkled fingers" from exposure to water causing low blood sugar readings?  Her bath is just luke warm not REAL hot.  She loves her baths and I'd hate to take that away from her at this point but I must admit I am afraid of the bath.  Could I be getting a diluted/false low result from the "pruney" fingers?

[Forum-vol-cmb]

I don't think that wrinkled fingers would effect her readings, but I would make sure that her fingers are dry.  It is a good idea to have very clean hands when you are testing because residual sugar on the fingers, from anything sweet could give a false reading.  Might I suggest testing her right before she takes a bath and then waiting maybe 15 minutes after she takes a bath.  You will find that with diabetes you have to adjust your life and your schedule a bit but you can manage diabetes and live a very normal life.

[JDRF-VOL-SG]

You don't mention the time of  day that she is taking her bath. If it is after dinner (before bedtime), it is likely that her dinner insulin is peaking while she is in the bathtub, bringing her sugar low. You don't say whether the baths happen every night or not. I would be more likely to suspect that the timing of insulin peaking is the problem if it is happening every night.

And yes, do make sure her hands are very dry before you test her. I have never noticed baths having any effect on glucose levels.

[Maddymom]

This has happened in early afternoon and after dinner.   She is on Novalog and NPH before breakfast and Novalog and lantus in the evening.  The fact that it has happened two different times in day is why I "hoped" this was a diluted reading rather than actual blood glucose reading.  This is all new to me and now I'm fearing the bath.  ho hum...Thanks.

[JDRF-VOL-RL]

After her bath her fingers are soaked with water.  Pricking her finger right after a bath will dilute the blood that comes out through that water soaked skin.  If you're going to test after a bath (or after coming out of a pool), make sure the fingers are as dry as you can make them.

[KevinHarney]

I think the problem centers on the fac that she is on Novolog and NPH in the morning and then she is on Novolog and Lantusin the evening.  NPH lasts 12-18 hours and Lantus lasts 18-26 hours.  I think those doses are overlapping.  My question to the Dr. would be why is she on Lantus and NPH??!?!?!?!?

It is important to note that a diluted blood sample will produce a diluted reading.

[JDRF-VOL-SG]

I agree with KevinHarney. NPH insulin is an older type of insulin, and it has a VERY noticeable "peak" action that happens in the middle of the day, around 3 pm. I grew up on NPH and really had to watch for mid-day lows. Most doctors nowadays use Lantus alone as the long-lasting insulin and have given up NPH altogether because of the scary lows that often happen when it peaks. Most diabetics in America who take injections rather than using a pump use Lantus once or twice a day and a quick-acting insulin like Novolog before meals. We do not normally take NPH with the Lantus, for they do similar things. Once the Lantus dose is right, NPH becomes unnecessary. I would suggest that you discuss this with her endo.