View Full Version : is this common?
We have been battling highs for ages now. It seems that the day after an insulin adjustment his bg`s improve ( a few days ago we had an in range day!). Then the next day he`s high again, and we up everything again.
We just keep repeating this every couple of days. Today we upped the am nph to 30, upped the nr scale 2 units (so he had 12 nr). We have trpled the nr since 2wks ago!
Kirsten
10-01-2007, 02:38 PM
We went through this pretty much the whole first year and a half post dx. I thought we might have to deal with it forever, but the changes have definitely slowed down in the past 6 months. I chalk it up to the end of the honeymoon.
Kirsten
What you are seeing is typical of the steadily increasing insulin needs during the "honeymoon phase".
In the honeymoon phase the body is still producing insulin, but the amount being produced gradually dwindles as the remaining islet cells in the pancreas die off.
We have tracked my daughter's total daily dosage (TDD) of insulin since diagnosis 14 months ago (August 2006). TDD fell steadily for the first month to about 7 units, by Christmas was 10 units, by Easter 15 units, by summer 20 units and we're now at about 25-30 units per day and climbing..
madde
10-01-2007, 03:01 PM
From what I have read it sounds like the end of the honeymoon? I don't remember ever experiencing a honeymoon with Madison's diabetes. But some people experience a very huge jump in their insulin requirements.
Has he had a complete blood work done lately? Checking thyroid function, etc?
I know what you are going through is sooo frustrating. But the only thing you can do is keep adjusting insulin dosages until they begin to fall into a more appropriate range.
Is it possible that he could be sneaking food? Madison does this sometimes, only to find her bs readings high for no reason- she usually confesses- once I have suspected this is what she has done.
I hope his numbers begin to straighten up. Diabetes management can become "hair-pulling."
Keep us posted on how things develop.:cwds:
payam7777777
10-01-2007, 03:25 PM
Today we upped the am nph to 30...
why nph??
please consider pumping or at least lantus/humalog instead of nph.
why nph??
please consider pumping or at least lantus/humalog instead of nph.
Why use lantus/humalog or pump?!
We have been using NPH successfully since diagnosis, in fact it has some distinct advantages that work well for us. It may generally be working well for this family too..
Many people posting on this site are down on NPH, but if one is properly taught how to work with it then I believe that (together with an appropriate bolus insulin) it provides a valid and useful method of managing Type 1 Diabetes.
madde
10-01-2007, 04:05 PM
I agree. We have had good success with NPH as well. No A1C over 7 since diagnosis. I can see where NPH would be really tricky with toddlers and very picky eaters. If I would give the pump a chance and find out it didn't work well for us, that woudn't mean it isn't great for a lot of people. Same with NPH.
I personally think that whatever treatment plan works best for your child - is the best.
why nph??
please consider pumping or at least lantus/humalog instead of nph.
We are switching. It`s just that if we went to Lantus right now when his bg`s are so wonky, there would be more variables, and it would complicate things.
The nph regimen is not working for us for reasons other than his high bg. But I think it can have success. If my son was younger I think I would prefer it.
Anyways, Lantus was only approved here in April/07. So before that it was the ONLY option.
Thanks for hearing my rant:D I don`t know why I`m so surprised by this. Maybe it hasn`t set in that he has diabetes:rolleyes:
We are switching. It`s just that if we went to Lantus right now when his bg`s are so wonky, there would be more variables, and it would complicate things.
The nph regimen is not working for us for reasons other than his high bg. But I think it can have success. If my son was younger I think I would prefer it.
Anyways, Lantus was only approved here in April/07. So before that it was the ONLY option.
Thanks for hearing my rant:D I don`t know why I`m so surprised by this. Maybe it hasn`t set in that he has diabetes:rolleyes:
Regarding the NPH not working for you - how is your son getting it? In one, two or 3 injections per day? We administer it in 3 injections:
- 40% at breakfast (with the bolus);
- 40% after school (with a small bolus for a pre-dinner snack);
- 20% at bedtime.
Works well for us. We were initially on two NPH injections daily, but found that spreading it out over 3 injections made the effects much more predictable.
He is getting 2 injections. This am 30nph, this bedtime 6nph. +nr 2xday.
I asked the d-nurse about breaking it up further, but she was hesitant to do so as he is so active (adding another peak) .
I also asked about adding the regular, but she said since our goal is to get on the lantus and pump in May, not to.
( all per your suggestions from my pm to you a few weeks ago- again thx so much wilf for your help!) :D
But we don`t like nph because of the mealplan, and having to eat when he doesn`t want to. Not neccesarily because of bg`s.
hey sorry i didn't clue in it was you.. May seems a looong time away, but you will need to decide what you want to do. In the meantime, what "mealplan" are you on?
I'm not aware of any mealplan specifically linked to getting NPH (as opposed to Lantus), aside from the fact that you want to have lunch around the time of the peak NPH effect from the morning injection.. But you'd want to have lunch anyway, wouldn't you?
hey sorry i didn't clue in it was you.. May seems a looong time away, but you will need to decide what you want to do. In the meantime, what "mealplan" are you on?
I'm not aware of any mealplan specifically linked to getting NPH (as opposed to Lantus), aside from the fact that you want to have lunch around the time of the peak NPH effect from the morning injection.. But you'd want to have lunch anyway, wouldn't you?
hehe..yeah, I guess he`d still eat lunch anyway.
By mealplan I meant "set" amounts of carbs, that must be consumed at certain times of the day to cover the nph.
Sometimes he doesn`t want to eat that much. Other times he wants more so I`m giving an extra shot anyway.