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Help with numbers...

Discussion in 'Parents of Children with Type 1' started by VinceysMom, Nov 17, 2011.

  1. VinceysMom

    VinceysMom Approved members

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    This has been our scenario the past 24+ hours:

    Nov 16:

    3 am - 57 ? 1C milk; -
    6 am - 90 (2 less units insulin due to low pattern developing);
    10:15 a.m. - 104 (2 units less again);
    12:10 pm - 53 (2 pks smarties);
    12:52 pm - 63 (3 pixie stix);
    3 pm - 65 - Special K bar uncovered;
    6:30 pm - 65 dinner ;
    10:15 pm - 91 (go-gurt uncovered);

    Nov 17:

    1:30 am - 47 (special k bar, juice box all 33 carbs uncovered);
    5:20 am - 139 (i honestly cant remember if i checked at 3 am!);
    10:15 am lunch at school today 53 (2 pks smarties, injection, off to lunch - he took 1 unit less than we told him which we had already decreased)

    The nurse will call me again shortly with another BG check.

    His carb ratio is currently 1:6 for breakfast (which the past two mornings I am shaving 2 units off the top). For lunch it is/was 1:10 and we shaved 2 units off and still going low. Today we did 1:12. Dinner is 1:6 but I shaved off 1 or 2 units last night because of the pattern of lows.
    He gets 29U Lantus at 6 pm.

    So, could all these lows be caused by Lantus? Ugh.

    Thanks for any insight you can provide.

    Kathy
     
  2. Christopher

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    Yes, I think the Lantus could be the issue here and it is what I would adjust first.

    Also, it appears you are waiting 3 or 4 hours after pretty significant lows to retest. I would test again 15 minutes after treating to see if he comes up. Just a suggestion.
     
  3. Becky Stevens mom

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    Yep, I agree with Chris. I'd start by lowering the lantus Kath. I know you just had to raise it recently by quite a bit if I remember correctly. And I know that is the frustrating and maddening part. We had to do the same thing awhile back, raised Steven's lantus to 21 units from 15 and are now back down to 18 units but sometimes less due to activity.

    It often happens that when BGs are in range for awhile our CWD are much more insulin sensitive and need less insulin. Where as before Vince was probably insulin resistant due to growth and persistant highs.

    If it were Steven I would start by lowering the Lantus dose by 2 units and do lots of testing, every 2 hours if you can and more after any lows that youve treated or highs that youve corrected. It will be similar to basal testing that CWD on the pump use to get their basal rate right. You may need to up the I:C ratios as well but I think once the lantus dose is right you'll find that the I:C ratios will work better as well.
     
  4. VinceysMom

    VinceysMom Approved members

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    Thank you, both of you.

    I know we should test sooner after those lows, but I look at his fingers and know that he dreads another finger prick. I ask him, "how do you feel" and he says fine...:( In school, he has missed so much of his two classes at the times he goes low, that he treats and runs off to class...

    I think tonight we will drop the Lantus... do you normally drop by one or two units?

    Thanks so much, I really do appreciate your comments.
     
  5. Christopher

    Christopher Approved members

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    You need to do what feels right for you and your son. But when you are talking about lows in the 40s and 50s, I think it is very important to recheck and not go on "feel". That is just me.

    As for school, is he not allowed to treat in class? That would save him a lot of time.

    If it were me I would drop the Lantus by 1 unit to start with.
     
  6. Butterfly Betty

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    I'd drop the Lantus by one unit, see how he does. I agree with retesting 15 to 20 minutes after those lows.
     
  7. VinceysMom

    VinceysMom Approved members

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    Yes, he can test and treat wherever, but he is not comfortable testing anywhere except the nurses office...sigh. He will go to the nurses office, test there, eat whatever to treat, and run back to class...sometimes tho, she does make him wait with her esp if he is in the 50's.. she wants to make sure he comes back up...
     
  8. mom24grlz

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    i'm pretty conservative when it comes to raising or lowering insulin. So I personally would lower the lantus by 1 unit and see how he does then. I know with Ashleigh it might take a couple days to see results from an insulin dosage change.
     
  9. wilf

    wilf Approved members

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    He's getting 29 units of Lantus. You can drop 2 units no problem, with numbers like these I'd have dropped the Lantus by 3 units..
     
  10. Heather(CA)

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    You need to lower the Lantus, because of the 47 I would start with two units, it's not like you can't put one back if he goes high...Also, I would not give milk for a 57. I would give juice to get him up, then depending on the number some milk to keep him up. I would re-check the lows too, at the very least at night. There have been many times after exercise that Seth has been low many times in a row.
     

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