I'm going to assume that 20 is the European numbers, which means it is 360 and VERY high. It definitely sounds like her family needs to learn more about managing diabetes. Numbers that high followed by lows means she is not taking the right insulin doses for what she is eating. They need to learn how to establish Insulin: carb ratios so that her bolus (mealtime) doses are geared to what she is actually eating.
Hi,
Sugar spikes are not only related to sugar, but mostly to carbs. Even if she doesn't eat candies, cakes, etc, she will still have spikes with foods loaded in carbs like white breads, white pasta, some fruits that are naturally loaded in sugar like grapes, for example. Her family should watch for her diet and include whole grains instead of white flour, fruits that are low in natural sugar, check her blood sugar often and the most important thing: have a talk to a diabetes educator. When I was first diagnosed I struggled so much because I couldn't understand how to balance my meals and after having a seeing a diabetes educator, boy my life changed!!! Also, 20 is a VERY LOW blood glucose, it is very dangerous... her family should keep a tight control with her blood glucose. I know it is painful to see a 5 years old being pricked but it is for her own sake... please urge her parents to look for "free diabetes educator, support groups, etc" especially in her local hospitals... sometimes they offer free seminars that will help her family to cope with her diagnosis and help her to be her best helper! Also, maybe if the family has insurance, they should consider talk to the little girl's endocrinologist and put her on a Insulin Pump... it was a blessing to me! Take care!