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Corrections question.

Discussion in 'Parents of Children with Type 1' started by Artgirl, Mar 13, 2016.

  1. Artgirl

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    I have a question about making corrections on the MDI regime. My daughter had a low number before lunch time at 3.0. She ate a bunch of things to bring it up. She tested an hour later and her number was 16 so she panicked and gave herself 3 units of insulin. Is it the right thing to do? Can you correct a high like that? I know you can correct a high at meal times but wasn't sure about how she did this. Thanks!
     
  2. Sprocket

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    1 hour after you eat is supposed to be the peak of blood sugar, 2 hours after, the range should be between 5 and 10. You're in MMOL's like us, so our target is 4-7 before eating and 5-10 two hours after. If she waited to see what she was at 2 hours, and she was still well over 10, I'd be inclined to correct at that point. You can correct with a meal dose or anytime. You just have to become aware of "insulin on board" and how much time left the insulin has to work before the next dose. For example, you wouldn't give 4 units to correct, then an hour later give a full dose of insulin for lunch. You'd be sure to go low. These calculations can all be easily done on MDI, you just have to become familiar with all the calculations. Think Like a Pancreas and Ragnar Hanas' book is also excellent and will give you a great foundation.
     
  3. nebby3

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    You can correct apart from meals and even so soon after a meal if you know what you are doing. Frankly 16 isn't that high so close to a meal and I would be inclined to wait and see what happens in another hour. Spiking after meals but then coming down on one's own is pretty common and often the lower you are to start the more you will spike. If you do at some point begin to feel comfortable correcting within the few hours after a meal you have to consider both how much short acting insulin is on board and what has been eaten and how long ago.
     
  4. Artgirl

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    She has this notion that if she is low at lunch like under 4 then she doesn't need insulin for her lunch meal.Not sure if this is a good way to manage blood sugars. She's been having a lot of highs i wonder if the honeymoon period is over.
     
  5. quiltinmom

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    Yes, you can correct between meals. I don't know if 3 units was the right amount, but you can figure that out if you know her correction factor (how many points one unit brings her down) and how many carbs she ate for the low. It seems she must have eaten too many carbs for the low, causing the roller coaster.

    I would guess she will still need insulin for a meal even if she is low beforehand, unless it is a very low carb meal. She will need less insulin, or it may be easier to think if it in terms of bolusing for all but 15 grams (or whatever number she would need to bring up the low) of the meal.

    Hope this helps. :)
     
  6. wilf

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    How old is your daughter again?

    And how is it that you're asking if a low BG before a meal means she doesn't have to bolus for a meal. A month ago I suggested getting a good reference text (e.g.. Type 1 Diabetes, by Ragnar Hanas) and making the most of your honeymoon break. Did you do that?
     
  7. Mimikins

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    So, your daughter was about 54 and then spiked to 288? How much insulin did she take with lunch?

    Personally, I like to stay on the conservative side and only correct if my insulin on board (IOB -the approximate amount of insulin that was injected that is still active within the body and can lower BG) is significantly less than what I would take for a certain number. For instance, my sensitivity factor is 1:80mg/dL with a target of 120mg/dL, so I won't correct if I'm at 250 with 3units IOB (3x80 = 240mg/dL potential drop), but I would correct if I was at 250mg/dL with 0.5units IOB (0.5x80 = 40mg/dL drop. If I corrected to 120, I would administer about 1 unit of insulin so that I would anticipate a drop of 110mg/dL and would end at around 140mg/dL).

    The big thing to remember is that you do not want to stack correction injections, or you risk having a severe low. My endo recommended that I waited at least three hours between boluses before I can correct for a high BG so that I am not dealing with significant amounts of IOB when figuring out how much correction insulin to take (I could take insulin to cover food at any time though).
     
  8. MomofSweetOne

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    It sounds like your daughter did very well. It is so easy to overcorrect lows when BGs are in the 50s or lower. Their brains are screaming to be fed. Our strategy to cope with those "eat-the-house" lows is to keep the freezer stocked with bags of frozen green beans. (Green beans have always been a favorite of my daughter's.) After she treats with fast carbs, if she feels like she needs more, she'll grab a bag and munch away until the urgency to eat passes. She then looks at how much of the bag she's consumed and doses for that. An entire bag of green beans is only 10g, so even if she forgets, it's not going to spike her terribly.

    And there is absolutely no reason to wait until a meal to do a correction dose when the reason for the high is already known. If she knew how many carbs she consumed, she could actually dose by her ratio.
     
  9. wilf

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    In answer to the question, your daughter did not really do it right.

    Just because you're low doesn't mean you bolus for meals. She should have reduced the meal bolus to account for the low BG - but you still bolus. If she had done that she wouldn't have gone so high afterwards.

    As for the 3 units of insulin and the question of whether that was a good amount, what is her correction factor?
     
  10. sugarmonkey

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    This is a good idea. When my kids were little if they were hungry while I was cooking tea I'd give them a cup of frozen peas. It stopped them complaining, and they were eating something that was in the meal anyway.
     

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