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Gummy worms...Any issues?

Discussion in 'Parents of Children with Type 1' started by Heather(CA), Mar 2, 2013.

  1. swellman

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    A full bolus for this mix is a sure low for us ... not sure that's the case here but a tummy can only digest so much so fast and throwing in a burger and fries with a high sugar side will always result in a low when fully covered at consumption.
     
  2. hawkeyegirl

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    Even giving the insulin afterward would plummet the vast majority of kids. I know that Seth has never needed an extended/split dose for high fat meals, but most kids do.

    Giving the insulin all up front is what caused this, guaranteed. We dose 70% up front (and by up front, I mean we probably predose about 25% and post dose 45%, for a total of 70%, and extend another 50%), but some kids need as low as 30% up front for a hamburger and fries meal.
     
  3. caspi

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    I agree. Way too much insulin up front for such a high fat meal. My son would have dropped like a rock as well.
     
  4. Heather(CA)

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    She didn't give any of the insulin up front. None.
     
  5. hawkeyegirl

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    As I indicated in my post above, "up front" in this context means either before or immediately after the meal in this case. Again, the vast majority of kids are different from Seth in that if you give all of the insulin for this sort of meal either before or immediately after the meal, they will go very, very low. They need an extended bolus (or a split dose if on MDI). Will she post here? Maybe I can explain it to her, because it's important that she NOT give all of the insulin before or immediately after the meal again.
     
  6. SarahKelly

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    that is how I use the term "up front" too...meaning as a normal bolus at time of food consumption or shortly after.
    With gummy or high fat/high protein we have to wait until we start seeing any start of BG rise. But again I think Isaac has slow digestion in general.
    Hope your friends daughter is fine and back home by now. No matter the cause it is scary to go through that for everybody.
     
  7. caspi

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    Heather, like the others have said, up front means all at once, whether it is before the meal or shortly thereafter. Is there any chance your friend could pop in on this discussion so that she can learn what others have experienced?
     
  8. Sarah Maddie's Mom

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    As in she gave a giant dose of fast acting...

    Do we know how it ended? I assume the girl is ok. What happened at the hospital? How did they manage it?
     
  9. Heather(CA)

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    No, at first I thought the gummy worms were completely separate from dinner. So the insulin didn't match up to the carbs hence the drop.

    Then I found out that she had eatten a burger and fries before the gummy worms so dosing for just the sugar was not the case.

    I called and asked her today exactly how the food/insulin happened....

    She ate the burger/fries, about 20 min later had the gummy worms. (Ate then quickly) 5 to 10 minutes after that she had the fastacting.

    I'm thinking the weather getting about 15 degrees warmer combined with more exercise is what did it. Or the insulin was off, probably some sort of combo for a LO. My friend said her ex didn't come over that night so that her daughter might have been less stressed too. Some sort of perfect storm. Crazy.

    She is fine, she ran her a little higher per the Endo on call. The Hosp did some blood work before they sent her home that night.

    Thanks for the input. :cwds:
     
  10. Nancy in VA

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    Did she have a seizure from the low? We've seen LO on the meter but she's been responsive and we've just treated her. We've only given Glucagon when she was seizing.
     
  11. hawkeyegirl

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    It's not "crazy" and it's really no mystery to me. Probably 90% of the kids on this board would have a severe low if 100% of meal dose insulin was given in this manner for a high fat meal. I don't know why you are completely ignoring the people who have suggested this in favor of your theory of warmer temperatures and stress being the culprit. Again, I hope you suggest to her that she post here, so she could hear from people who have experience with split doses/extended boluses.
     
  12. swellman

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    Yea, I'm also scratching my head here. Substitute ice cream dessert for the gummy bears and we have a Friendly's meal and if I didn't split/extend that I'd be giving glucagon every single time.

    Apparently Occam's razor doesn't apply to gummy candy. :rolleyes:
     
  13. mysweetwill

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    It sounds like at least three of you think the high fat meal without a combo or extended bolus was the cause of the low. And are pretty sure the large majority of kids would tank if a combo or extended were not used. We have never used a combo or extended bolus. Not once. In fact my son had a burger and fries tonight. Had his usual bolus and in fact now, four hours later bs numbers are doing the creep up we sometimes get between 10pm-midnight. Looking at his dex he had the usual post meal bump but nothing remarkable. Sounds like we may be in the minority, but Id love to hear if truly most of you use these types of boluses for high fat foods.
     
  14. swellman

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    Let us know if you have to bolus overnight ...
     
  15. nanhsot

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    We dose just as your describe for pretty much all meals except maybe pizza (which he almost never eats anyway).

    I've not contributed to this thread because I have nothing to add but wanted to respond to your direct question. My son doesn't really change how he boluses based on fat content, I'm sure he SHOULD, but I know he does not. We don't see problems with lows after high fat meals.
     
  16. swellman

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    It's possible that some of the differences are how a 12 year old or younger can eat and digest a 120g CHO, high fat meal compared to a 16 or 18 year old. I can totally see where an older child/young adult may process the same meal very differently.

    EDIT: It's also possible that there are other digestive issues involved as well.

    I think the issue is assuming that all children react the same way for similar foods.
     
  17. Sarah Maddie's Mom

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    It seems sort of silly to be even having this conversation.

    I know nothing about this kid. No time since dx, no feeling for her D history, nothing. It's all half-baked and incomplete information about a "low" that resulted from who-the-heck-knows :rolleyes:

    In the end this mystery kid is ok and for us to further debate the vagaries of her situation as it related to our kids and how we bolus is kinda silly.
     
  18. swellman

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    ouch ... but point taken ...
     
  19. mysweetwill

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    I dont think its silly. When I read something that many of the "regulars" who I've come to respect here are agreeing upon and its something I've never experienced, I like to learn something new.
     
  20. Sarah Maddie's Mom

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    I agree that a "do you extend for high fat meals?" thread would be a good one. A discussion of that same topic tacked onto a thread about gummy worm carb counts might not be the best place to have it. That's all I'm saying.
     

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