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Another help request with numbers

Discussion in 'Parents of Children with Type 1' started by monkeyschool, Apr 21, 2011.

  1. monkeyschool

    monkeyschool Approved members

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    I feel like I keep going back to the same questions over and over :-( I apologize in advance as I know I posted this not too long ago before we tweaked doses.

    Lantus was dropped one unit last Friday (to 9 units), we also dropped breakfast from 1:22 to 1:26 and lunch from 1:26 to 1:28 over the weekend .....dinner we left alone at 1:30.

    This is where we are....Dinner last night was at 9PM (as well as Lantus)....

    11PM 2hr post was 139....
    1AM dropped to 102....since the number was dropping and we expect a bigger drop around 3am bec of Lantus peak we did 7g carb.

    3am 112 (it was probably higher before bec of snack, but dropped with Lantus, this is what we typically see)

    5am 111

    7am 95

    8am 82

    9am 71 (breakfast & novolog at this point, we gave free juice to compensate for the low)

    +++++ at this point I am questioning the number continuing to drop ... should Lantus be holding higher at this point..meaning our dose is still too high?


    11AM 99 (2hr post)

    12PM 76 (7g carb)
    12:30 88
    1PM 69 (10g carb)
    1:30 73
    1:45 80
    2PM 76 (13 carb)

    ++++ these last couple of numbers were also 4+ hr post Novolog, are they indicative of Lantus???

    2:30 lunch .... since we were hitting lows and were having a wrap which seems to hit later spikes than we cover with pre-meal novolog we delayed Novolog until 3PM

    5PM (2hr post) 220
    6:30 (going into karate) 146
    7PM 133
    7:30 (after karate) 96 (7 g carb)
    8-9 (tumbling) 15g carb sipped throughout class
    9:20PM 87
    ++++this chunk I am good with, dropping through activity and carbs to compensate



    9:30 PM (dinner and lantus) since we had pasta I delayed Novalog by 40 min .... tested 9:50 @99, waited for a bit more rise
    10:10 PM before Novalog shot 124
    12:10 AM 2hr post 95

    ++++ this is where we are now. I am debating snack/no snack. On one hand I want to give something to bring number up, on the other hand I am expecting the pasta to hit soon .... which means snack will sky rocket night numbers.


    Does the dropping through the day mean Lantus is still too high? (the carbs we keep giving though the day are not desired, btw - we keep giving them when she feels like she is dropping and test lower than we'd like).

    Thank you all again in advance,
    D.
     
  2. bibrahim

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    When we were on lantus, we based the dose changes partly on the AM number and if it was less than 120 we would usually lower it. We gave ours at 9 also. We also had to feed the insulin...hated that part.

    For every hour of activity we gave 15 unbolused carbs. I wouldn't feel comfortable putting her to bed at 95 so would either recheck or give a snack. We also found that our lantus wore off in the evening so you might be seeing that in your 5pm number or it might be due to giving it after eating.

    I would call your endo to go over this stuff since it is still pretty new. Sorry I can't be more help. I just decided to post since no one else had posted yet.
     
  3. Judy&Alli

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    I think you are close, but I think I:C and Lantus need to be changed, meaning less insulin.

    Your 2 hour PP are on the low side, and also the lantus was looking ok until you said he had a 7 gram cho snack, which means the Lantus is a smidge too much.

    Also for tonight I would give an uncovered snack.

    HTH, good luck:)
     
  4. Ali

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    In general if you are dropping all the way through any 12 hour period you have too much basal. If you are always low 2 and 1/2 to 3 hours post meal you have to much bolus insulin. If you are always a bit trending high to little basal. Always high 3 hours post a meal too little bolus insulin. The truth is that with various exercise, food choice, sleep schedules, stress issues, growth hormones, maturity hormones, etc. the ability to keep a person, and especially a child at a constant BG level without adding some food or some insulin during the day is very very hard. I suspect you will find that most of those on this site add some extra food, extra or reduced exercise, extra or reduced insulin on almost a daily basis. As an adult with a very stable body chemistry/hormonal status I too snack and adjust insulin constantly. What you are looking for is general trends out of a big range. Usually basal ups or downs of more than 30 points in a few hours without food. For post meal numbers I will let others chime in. Good luck. Work with your Endo the more he/she knows about your child the more they can help. :cwds:ali
     
  5. monkeyschool

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    Thank you. I rechecked her at 12:40 and the pasta was kicking in 125 :) wll check again in 15 min to be safe.....I can't get to bed until the Novalog wears off (another downfall of late dinners :-(

    We tried 15 carb, but the numbers were going too high...she is a tiny 12yo (57 lbs) so we've been playing with amounts lately - somewhere between 7-10 seems to do the trick/hour...for right now anyway. Is there a better way to find a good snack size?
     
  6. monkeyschool

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    Thank you - That's what I am thinking as well. I was told the 2 hr post should be appx 30 off from starting number....should I be looking at the 3 hr number instead of the 2 hr number? Would that give me a better idea?
     
  7. monkeyschool

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    Thank you so much :)
     
  8. monkeyschool

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    We're up to 177 now....pasta has definitely started it's late kick- in ....
     
  9. monkeyschool

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    by 3AM our "pasta' climbed to 202...right before Lantus peak. By 8:15AM bg was down to 96....no correction.

    If I continue to see this with pasta, is it off to try to give half of the Novalog 30 min after eating and the other half 2 or so hours later?
     
  10. Abby-Dabby-Doo

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    Have you ever considered giving the Lantus in the morning so your child can be alert and awake for the Lantus "drop"?
    It's just an option.
     
  11. Judy&Alli

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    I am thinking the basal is pulling him on the low side and I wouldn't change the I:C ratio until you get the Lantus set right. I really think with you being newly dx'd that your endo should be alerted to these bg numbers.:cwds: Good luck!!! You are doing a great job:)
     

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