We are having a problem with my son's BG dropping in the afternoon. He gets insulin with his lunch at 11:30. He has PE every day right after lunch so he re-checks at 1:30. Lately He is usually 160-190 at this time. When he comes home at 3pm he is often low...between 55-70 many days, some days in the 80s.
I lowered his lunch bolus dose a couple of weeks ago from a 1:20 to 1:25. He used to be in the 120 range at 1:30pm when he was getting 1:20 at lunch. It did not change the 3pm number very much though. So I have been lowering the basal during the afternoon. I am lowering it between 1-4 pm. He has gone from a basal of .45 during that time to .25, but we are still seeing about a 100pt. drop between the 1:30 BG check and 3pm. Nothing I do seems to be helping that 100 pt. drop. Since reducing the 1-4 basal I have noticed that he is now having some very high BG before dinner (or maybe its a rebound from the lows).
Here is an example of what we have been seeing:
11:30 169 Lunch bolus plus correction
3pm 54 treated low, then he ate a snack with bolus
5:30 314 correction given
I used to think the PE after lunch was the problem, but he has had the Health portion of PE the past week where he just goes to a classroom with no activity and we still are seeing the same problem. But this does not happen on the weekend, only on the days he has school. Whether or not PE is the problem, I just need to figure out how to fix it.
Am I lowering the basal at the wrong time? or is it possible that the lunch bolus is still dropping him that much? That would be very unusual for him becuase we ususally notice that he drops very little if any between 2-3 hours after his boluses.
Any thought on what you would try?