What are your tips and tricks for rebound highs?

[Adinsmom]

I suspect Adin had a rebound high last night. It could have been a growth spurt and hormones? :confused: He had a stubborn high that just wouldn't go away no matter how much insulin I was throwing at it. Today has been a topsy turvy numbers day because of it.

I know I have seen tips about what to do for rebounds. I think HeatherCA has a couple and maybe Lee? :confused: Anybody have any advice for me? Or want to walk me through a night and what you do when your child has a stubborn high?

Thanks.

[Chaser]

Shelley,

When Chase has a stubborn rebound high or just that "mysterious high" I find that I can bring him down faster with a higher temp basal then with a correction. Maybe not "faster" but I don't find myself later with another low. Sometime I will use a dual wave bolus in order to give him a little upfront.

[shekov]

When using the temp basal.....How do you know how much to increase it?? Is there a "rule of thumb" or is it experience?

[moco89]

The only thing I have to say about rebounds is that the high will react faster to insulin, and therefore the BG will drop faster than "typical highs". It's important not to over-correct in such a situation, or you just cause a vicious rollercoaster of extreme highs and lows.

[tuckerk]

I have noticed that same pattern with Caitie. If it is time for a meal, usu. will give her routine dose of rapid acting (1 unit) and re-check in 2 hours. If she is not in range then will mini-dose insulin over a few hours. When we have given the correction factor+ routine dose for a rebound high, she has plummeted!!!! It never fails.

[Lee]

My kid is older, so when it is a stubborn high - we give the full correction PLUS a 20% increase temp basal for two hours.

I am not sure why, but it makes her come down much easier then just the correction.

I have found with the stubborn highs, that I correct and correct and correct and correct and it takes HOURS!!!!! (Ps - not stacking because the IOB feature on the pump); but the correction and the temp basal - golden!

But- test alot just in case!

[momtojess]

When we get stubborn highs ( I used to think they were reboung highs, but after seeing cgms, they arent rebounds :rolleyes:), we do a full correction plus 30% temp basal for 2 hrs, and recheck.. She is usually well on her way down then.

[saxmaniac]

Rebound highs are rare for us, and I tread VERY lightly when correcting them. 1/3 to 1/4 the usual rate of insulin, if at all.

If they are stubborn, then it's usually not a rebound. Temp basals are really effective for bringing them down. I am using them more and more. It's amazing how 0.1 unit spread out over an hour or two can be far more effective than .5 or 1 unit all at once. I don't get it!

[wilf]

We find that we just have to "get through" rebound highs. In our case that means sticking to our normal regimen of correcting any highs with the next meal-time injection to aim for the "zone of perfection" (80 to 120). If it is truly a rebound, then the after effect lasts about 12-15 hours and typically by the time we've figured out that it's a rebound we're pretty much through it.

A different matter entirely is when for some reason DD is "stuck high" for more than 15 hours, with BG levels over 250 and just not coming down despite our best efforts including drinking lots of water and/or some exercise. At those time I take a radical approach, and give enough insulin to correct down to a BG target of 0 mg/dl, and then monitor frequently and "catch" DD on the way down by starting to feed carbs as we approach the target range. This is not for the weak of heart or inexperienced (don't try this at home kids..), but it pretty much always works.

[twodoor2]

For any type of stubborn high, I use a full correction (sometimes a double correction) and a temp basal of 100% to 150%. The length of the temp basal is determined by testing frequently, and seeing if the number starts to come down. When it's near or in range, I cancel the temp basal. I usually do them for about 2 hours.