View Full Version : Why is this happening?
Bsbllmom
01-02-2008, 02:14 PM
Last night before bed Christian was 298. I gave him a correction of 1 unit. He gets 1 unit for every 100 over 150. So I figured it would take him down to 198, he also got his 11 units of Lantus. So at 11 I tested him and he was 160, good he was coming down and that was 2 hours after I have him his 1 unit. Well this morning he was 237:eek: So I gave him 1 extra unit for breakfast. I just had him test right now and he is 424:eek: I just called the endo office but I got an answering machine. I will try again.
Sounds like he may need an increase in the Lantus dose.
getting sick????????
has some infection somewhere????????
too much basal (rebounding from a nighttime low) ????????
too much correction and rebounding from low (the 424)????????
not enough basal (needs more now) ?????????
growing????????
a combo of one or more "factors"???????????
Isn't the "guessing game" frustrating some times?????????:mad:
Hopefully the endo can help you out if they answer their phone!!!!;)
Have you seen these type numbers for a couple of days?or just one day so far?
Bsbllmom
01-02-2008, 02:38 PM
Well he just finished antibiotics for walking pneumonia. He still has the cough and some congestion. I talked to the CDE and the endo said to do correction and test every three hours. Keep doing corrections and checking ketones. Oh I hope this passes soon. We were going to go do Disneyland today. Do you think I should change our plans?
phil413
01-02-2008, 02:39 PM
When did you change out Lantus? I have found that it lasts for us a maximum of 28 days, but I have had to change it a couple of times around 20 days...
Bsbllmom
01-02-2008, 02:40 PM
He has been going up and down but staying in the 200's. This is the highest I have seen him since dx.
Unless he has keytones,or feels bad I would not changes my plans.
Bsbllmom
01-02-2008, 02:42 PM
I actually opened a new Lantus after his dose last night. It was just 28 days. I was wondering the same thing when he woke up high this morning. I don't know why I didn't give him his dose out of the new bottle.:(
If his B/G is staying over 200,then I would without a doubt say he is not getting enough insulin. But I'm not an Endo.May I ask what was his last A1C?
Mary Lou
01-02-2008, 02:47 PM
Changing plans is such a tough question. Is he tired? Feverish? Maybe a delay of one day would give everyone a little more rest. Maybe you can't change things so easily. Trust your instincts.
We often see crazy numbers after illness. Even though it's almost a knee jerk reaction to increase basals and carb ratios, I think it's best to see if this happens again today. Wait...you said he was continuing to rise. >sigh< Check. Correct. Check again...
Was the 160 the last night check? I know that if one of my boys dropped that much in 2 hours, I'd want to know where they were in another hour (or two, depending), just to be sure that they were leveling off in range and not continuing to drop.
Good luck!!! I really feel for you...we're battling highs right now, too..
Bsbllmom
01-02-2008, 02:48 PM
Well he has had a few numbers over 200 it so sporatic though. He wakes up in range and throughout the day he will go high and then back in range. I think it is because he has been sick.:confused:
twodoor2
01-02-2008, 02:59 PM
Last night before bed Christian was 298. I gave him a correction of 1 unit. He gets 1 unit for every 100 over 150. So I figured it would take him down to 198, he also got his 11 units of Lantus. So at 11 I tested him and he was 160, good he was coming down and that was 2 hours after I have him his 1 unit. Well this morning he was 237:eek: So I gave him 1 extra unit for breakfast. I just had him test right now and he is 424:eek: I just called the endo office but I got an answering machine. I will try again.
I don't care for the scale method, and this is precisely why (BTW, how do you dose if he's 175 for example?). Most people use the correction factor formula, but regardless. . . if he's going high after all his fast acting wears off, it's probably the lantus. If he's going high 2 hours after the fast acting was given, then it's probably the fast acting. It could also be a combination of both. Since he was much higher this morning than he was after you gave him fast acting, I suspect it's the Lantus.
You may also have a bad bottle of insulin, but that may be less unlikely, although it is in the realm of possibility. I also keep my Lantus refrigerated, even though it burns more, it helps to retain the potency. Lantus is more sensitive to room temperature conditions than Novolog, for instance. I personally have noticed that it loses strength faster if it's kept at room temperature.
Bsbllmom
01-02-2008, 03:31 PM
His last A1C was 7.1.
He has been going up and down but staying in the 200's. This is the highest I have seen him since dx.
Have you been correcting with every injection?
If it was a rebound high, it should start to come down by this evening.
If it is something else, then at the latest tomorrow I would give him bigger than usual corrections to bring him down for sure.
How much insulin is he getting per day right now (all insulins added together)?
Nancy in VA
01-02-2008, 05:33 PM
I would vote for the Lantus. We had to change ours every 22 to 23 days - we started to creep up after that
Bsbllmom
01-02-2008, 05:51 PM
I will see how he does after tonights dose with the new Lantus. Right now he was 279. The endo said to test him every 3 hours and if needed give a correction. It depends on what he eats during the day but he usually gets 15-20 units of humalog and 11 lantus at night.
Thanks everyone for all of your replies. I was hoping that I wouldn't hear that I have to rush him to the ER. So far everything has been pretty smooth sailing with D but I know somewhere lurking is a problem that will be hard to deal with. I thought this was it but it seems like it is going to be ok.:cwds:
As long as he's getting insulin he shouldn't need the ER (if if he's stuck high for awhile)..
Do you measure at night? Maybe do so tonight to make sure there's no lows with the new Lantus. Also, I wouldn't correct any later than 6 pm, to make sure there's no night-time lows.
he usually gets 15-20 units of humalog and 11 lantus at night.
Using the 1800 Rule conservatively, assume he's getting 30 insulin units per day so 1 insulin unit should bring his BG level down by 60.
Is that about what you're working with when correcting?
Bsbllmom
01-02-2008, 06:23 PM
I'm using 1 unit for every 100 over 150. So am I to assume that 1 unit is supposed to bring him down 100 points?
I'm using 1 unit for every 100 over 150. So am I to assume that 1 unit is supposed to bring him down 100 points?
Yes, that's how that would work. So what the 1800 Rule suggests is that this scale needs to changed, and that the corrections being given will not be enough to bring him back into range.
Bsbllmom
01-03-2008, 02:07 PM
Ok we ended up going to Disneyland yesterday. We had lunch at home and he was 279, covered his lunch and gave correction. That was at 1:30. At 4:30 he was 378, gave a correction. At 7 he was 116. We ate dinner. At 9:14 he was 120, gave Lantus, new vial. At 10 he was 113. At 11:30 he was 103, 1:00 he was 74:eek: Gave him a 23 carb juice. Let him go to bed and I checked him at 2:00 A.M. He was 155. At 8:39 he was 151:) So I think it is over. I'm sure all that walking helped. Thanks for all of your opinions and support. You guys are the best.:D
Glad to here you guys had a good time,and that all went well.Do you normally see lows at night,and highs during the day? Looking at those numbers you might want to ask about splitting up the Lantus dose,or giving it in the morning.Just throwing ideals at you. Have you considered a pump?
Bsbllmom
01-03-2008, 02:31 PM
Glad to here you guys had a good time,and that all went well.Do you normally see lows at night,and highs during the day? Looking at those numbers you might want to ask about splitting up the Lantus dose,or giving it in the morning.Just throwing ideals at you. Have you considered a pump?
We don't usually see lows at night. Sometimes around lunch he will be a little low at school because of recess in the morning, especially if he plays basketball. Actually since he started on Lantus/Humalog he has been having great numbers. It is just when he got sick after Christmas that his #'s were all over the place. We will be ordering our pump in April at our next appt.:D
We don't usually see lows at night. Sometimes around lunch he will be a little low at school because of recess in the morning, especially if he plays basketball. Actually since he started on Lantus/Humalog he has been having great numbers. It is just when he got sick after Christmas that his #'s were all over the place. We will be ordering our pump in April at our next appt.:D
He may be about to go through the same thing my son is about to go through the big P (puberty) Our endo told us on our last visit to not be too surprised it we start to see some unexplained highs.
Bsbllmom
01-03-2008, 02:53 PM
Yep he will be 12 next month.:) Some D things are new to us because it hasn't been a year yet. We haven't had to deal with an illness until now and I am sure there are other things like puberty that are coming my way. We haven't had to deal with ketones yet or had to treat severe lows. So I feel like I am still on a learning curve. So hopefully this has passed successfully. All I have to say is bring on the next hurdle.:D