HELP, Seth is on vacation with his dad...

[Heather(CA)]

Hi everyone...I need some ideas. Seth is on vacation with his dad in Lake Havasu AZ. He has been good after dinner, then waking up in the mid to high 300's:eek: He is not too bad during the day, but he is going up betewwn meals after the Apidra wears off. They have already upped the Lantus from 21 to 23 units with no affect. And, his step mom has already changed the bottle once. She stayed up last night and said he went up steadily, so I'm assumng no rebound...Here are my thoughts, what do you think?

I'm thinking either his hormones are going crazy, he is in puberty. Although it has never gone up this fast before:confused:

or most likely?

The Lantus is bad. I wonder if it could have gotten too cold in their ice chest? (8 hour drive) So that all the Lantus they took is bad. It is very hot there so they have been VERY careful to not let the insulin get hot.

I have noticed that heat affects the Apidra faster than it does the Lantus. I wonder if the cold affects the Lantus more than the Apidra??? What do you think?

Thank for your input....Heather:)

Oh yea...No keytones thank goodness;)

[Nancy in VA]

Sorry, I don't have much to offer but just wanted to say :eek: to 21-23 units of Lantus. My little one only gets 3.5 units. I can't IMAGINE having to give an injection that big.

Teens are tough. Heat makes your personal blood sugar go up so if its hot (you said it was), the insulin needs are going to go up. BUT, if he's active, he'll be burning more carbs so you have to balance the activity with the heat.

[Mommaof7]

I was told that unless it's freezing temps, that keeping Lantus in an ice chest wouldn't damage it. If it's truly that hot there, how is his hydration? Lots of fluids?? I would wonder if that's part of the problem.

[Jensmami]

I'm not much of a help, because I'm still new to this. Two weeks ago we went on a vacation, and my daughter was high all the time. We gave her more Levemir and Novolog and nothing helped. First I thought the insulin was bad, but then we came home and her numbers went down. I don't know what it was, different food, different activity level:confused::confused: Maybe Seth's bg needs to adjust to the environment.

[Mrs. Russman]

excitment??
our cde told us that numbers might rise the first day or two of camp from excitement.
I would think that unless it was frozen, the Lantus would be fine.

Hope you get it figured out.

[Mama Belle]

My bet is on hormones combined with the heat. It is my understanding that teens requirements go up a ton at night and first thing in the morning with all of the hormonal changes. Plus you've got the excitement factor in there too.

It could be that the Lantus got too cold, but I would think that if he was getting no basal insulin he would have ketones.

[jeep_bluetj]

I seriously doubt you'd get 2 for 2 bad lantus vials.

I needs have gone up. Heat, excitement, whatever. But it may be temporary.

So, imho, you've got a few options.

1. Let it ride, and just correct in the AM (maybe even earlier).. This isn't too bad of an option, really. (And I'm assuming this vaction is just a week or two).

2. Up the lantus some more (like another 2 units).

3. Split the lantus. If you're giving AM, it may be wearing off by PM due to heat -- If you're getting lows during the day, it may indicate this is happening.

My kid? I'd go with #1. Because every time I get nittime highs, they last for 3-4 days and return to normal. If I made a basal adjustment every time, I'd end up with lows. And he's on vacation too. So everything's gonna be wonky.

But I'd also insure complete hydration. Not just 'cause he's D, but because that's what you need to do in the desert.

[Heather(CA)]

Yea, keep giving me suggestions, but I'm leaning towards hormones too...I found out that the Lantus he's being given was NOT in the ice chest, just his blue bag. It would not have gotten frozen in there. He gets his Lantus at night, so it's not wearing off...Thanks for the dehydration tip, I had forgotten about that one. He normally drinks lots of water, I'll tell them about that one.:D

[Heather(CA)]

The ex called the endo, they upped his Lantus by 2 more units...That means he went from 21 to 25 in 4 days:eek: Wow, puberty stinks, I hope they're right.

[kiwikid]

Its great they are keeping in contact with the Endo AND with you! At least you know whats going on :rolleyes:

[Heather(CA)]

Its great they are keeping in contact with the Endo AND with you! At least you know whats going on :rolleyes:

Yes, my ex can be a stinker about that, thank goodness for the boys step-mom. She's keeping me posted. I owe part of my sanity to her LOL

[Mama Belle]

Yes, my ex can be a stinker about that, thank goodness for the boys step-mom. She's keeping me posted. I owe part of my sanity to her LOL

I have uttered these exact same words many times (that is before my ex split from his second wife).

[Heather(CA)]

I have uttered these exact same words many times (that is before my ex split from his second wife).

Oh no...I bet we could share some stories LOL...:rolleyes:

[Momof4gr8kids]

I think all of your ideas are good ones. You are probably right on. Here is one more to consider:

Since you said he is camping I'd bet he is extra active. Sometimes when Julia is extra active her body seems to react and give extra glucose, not only when she needs it, but at night too.

Just another idea to consider. I hope you guys can get it figured out. It must be hard to have him so far away, and running high at night.
Take care, Jamie

[Heather(CA)]

I think all of your ideas are good ones. You are probably right on. Here is one more to consider:

Since you said he is camping I'd bet he is extra active. Sometimes when Julia is extra active her body seems to react and give extra glucose, not only when she needs it, but at night too.

Just another idea to consider. I hope you guys can get it figured out. It must be hard to have him so far away, and running high at night.
Take care, Jamie

Good idea, that was my first thought too, maybe a rebound or adreneline, But the step-mom stayed up testing him and he only went higher. Also, they are at a Lake, but they are staying in a hotel, she also said he hasn't been THAT active. Good thought though, I had the same one. He's been bitting his nails a lot (that startd at dx'd) it could also be an infection, or he's haveing a gigantic growth spurt/hormones. His step-mom said "he looks bigger" Who knows, he's good during the day and was down to the low 200's last night, a little better Thanks for your post (smile)

[lilituc]

Is there a significant difference in elevation there?

[Heather(CA)]

Is there a significant difference in elevation there?

No, I don't think so..AZ is pretty flat like Fresno, CA isn't it?? Why do you ask?? I'm intrigued;)

[lilituc]

No, I don't think so..AZ is pretty flat like Fresno, CA isn't it?? Why do you ask?? I'm intrigued;)

Oh, just that many people find their insulin needs change if they take a trip to a different elevation (some just for the first few days). I hear most people find they need less insulin at a higher elevation, but I went to Tahoe recently and I needed about 40% more insulin.

[Heather(CA)]

Oh, just that many people find their insulin needs change if they take a trip to a different elevation (some just for the first few days). I hear most people find they need less insulin at a higher elevation, but I went to Tahoe recently and I needed about 40% more insulin.

Interesting...I'll keep that in mind. We might be going to Reno in a couple of weeks:cool:

[MrsBadshoe]

When my son was going through puberty his night time needs went up by leaps and bounds. They do most of there growing over night hence the need for extra insulin overnight. I also vote for hormones.

[3js]

heather, how is your son doing? hope all is better!:)

[3js]

bump:) this really hits home for me as i am so worried about my son being away from us now. did the dose change do the trick?

[Mama Belle]

Yeah, how are things going heather? I sent you an email. :D

[Heather(CA)]

The nurse they talked to reported back to me that he went to bed at 207 and woke up at 205. At least the Lantus is right now...He will be home tomorrow...I'll get him straight over the weekend:D Thanks for all your concern and suggestions. :cool:

[LantusFiend]

When Lantus is left in the sun, it becomes shorter acting.
If I'm waking up high after lowish numbers in the day, and I don't have another bottle or haven't been on that one for a month yet, then I split the dose.

[Heather(CA)]

Here's an update:rolleyes:...Seth just got back frome vacation and he has a double ear infection. No swimming for 3 weeks:eek::(

[Mama Belle]

Ugggg ... poor Seth!! No wonder he is high!!! :(

[Heather(CA)]

Seth has been great all day...141 before lunch, 112 three hours after, 97 before dinner, the 47 3 1/2 hours after:eek: Hmmm, that Lantus may be coming back down...We'll see..