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Here we go again summer time lows finally have example

Discussion in 'Parents of Children with Type 1' started by fortristan, Jul 30, 2007.

  1. fortristan

    fortristan Approved members

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    I wanted to show you guys this. I started having big issues about 3 months ago. I tried telling the endo PA but she was gone on vaction everytime I called. Talked with nurse and she said she didn't see a pattern (sound familier). Saw a new Dr. he said #s were great keep it up. I tried telling all of them that I'm fighting lows. Since 3 months T has been sick alot (which has helped keep his #s up. Also we've been getting better at keeping them from bouncing over 40mg one way or the other. We use injections (mdi is that right?) Don't be alarmed by the carb amounts he eats a lot and is actually gaining. We've been having some scorchers the past 2 days and I can see the lows coming back and we'll be reducing doses again. Keep in mind T is overcoming a cold/flu. Here's 3 examp. the last one he's not sick. We've tried increasing carbs, we would finally get to where he would raise to the 200s so we would increase H by .5 it would be to much.

    Today 7/29
    9:46/82mg/1.5h-18g carb/?g pro
    11:39/71mg 1 sm candy
    2:45/99mg/1.5 h-45g carb/23g pro
    8:26/82mg/1h-18g carb/34g pro
    give lan at 1:00am after night chk, will reduce to 2u

    Yesterday 7/28 carb and pro amounts about the same
    10:03/135mg/1.5h
    12:20/109mg felt low and treated
    1:24/124mg
    2:25/163mg/1h lunch
    6:38/102mg
    9:03/111mg/1.5h had pasta alfredo
    10:31/47mg-sip of milk
    12:32/108mg
    1:22/129mg/2.5 lan

    6-10-07
    8:43/89mg/.5h-22g carb/22.5g pro
    12:08/97mg/.5h-26g car/8g pro
    6:27/62mg/1uh-40g-50g carb/pro ?
    10:03/49mg/2 lan given after treated
     
  2. 3js

    3js Approved members

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    hi, is the mg the bloodsugar reading? i`m not sure if i`m reading it right.
     
  3. Amy C.

    Amy C. Approved members

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    Comments that you can take or leave:

    Breakfast: 12:1. If he had the same amount of carbohydrate on each day (18), I wouldn't have given the same amount of insulin. There is a difference between a starting blood sugar of 135 and 82. Based on the reading a short time later, I would have given 1 unit on Saturday and maybe a half unit on Sunday.

    Lunch: 45:1 or 30:1? Be aware of the starting blood sugar. You gave 1 unit for 45 grams when he started at 163, but the next day you gave 1.5 units for 45 grams when he started at 99. I would have given 1 unit on Sunday.

    Dinner 12:1 On the 28th, when he was 47, I would conclude that 1.5 given was too much for the dinner of pasta alfredo. I wouldn't choose milk to raise a low. Glucose tabs work for my son. Milk is not fast acting.

    There was a long span of no testing. 8 hours is a long time to go without a test. No telling what happened in that time period. If you are giving the Lantus at 1 am, he may be going low in around 6-7 am.

    I would start by going to a different ratio -- more carbohydrate to the insulin that what you seem to be doing. I would also count the carbohydrate very carefully -- even that given for corrections and to be consistent in the ratio. It is hard to determine what is going on unless there is a consistent ratio.

    It is good you lowered the Lantus, that should help with the readings today.
     
  4. Heather(CA)

    Heather(CA) Approved members

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    Those are pretty good #'s, I also agree with the fact that you lowered the Lantus, waking up in the 80's is a bit low for me...

    I also agree with Amy that I would not use milk to get him up from a 47. We use the Juicy juice boxes, 15 grams and 100% juice. I use 1/2 a cup of milk if Seth's 70 or above and I want him over 100 at bedtime. Not to treat lows.

    Looks like he was quite low after dinner twice, it doesn't look like it was easy to judge, but you might want to raise the I:C ratio at dinner too..

    Hope this helps:cwds:
     
  5. Mommaof7

    Mommaof7 Approved members

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    I'm just curious, with the lantus, if I'm reading that right, your giving at night?? We had a huge problem with night lows and stopped lantus at night and only gave in the morning, he now gets 2 units lantus in the am instead of night and our nightime numbers are pretty perfect. We are using novolog for the rest of the day. I have to say, for Zech if he was 82bg and then only 18g carbs, I wouldn't give him anything, it would drop our son fast. I know it's different for everyone, but for us, he gets 1 unit for every 20carbs, if he has like 35 carbs we'll do 1.5 units. As far as the bg goes, he doesn't get any insulin for the sliding scale til he hits 180. For 7/29, you gave the same amount of insulin for 18g carbs as you gave for 45g carbs at lunch, that may have been the reason for the mid-morn low. I'm new to this, but just what I'm seeing. This disease is so nuts, it's like shooting craps sometimes ya know!
     
  6. Nancy in VA

    Nancy in VA Approved members

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    I'm not understanding your chart at all, unfortunately, but the one thing we have discovered is that Emma has different C:I ratios at each meal. She needs more insulin after breakfast than she does at dinner, for example (Breakfast - 18:1 and Dinner - 32:1). How much we bolus for food is completely separate from her BG reading. We determine her bolus for food and THEN determine if we need to increase or decrease based on BG. We do no correction between 80-180, negative correction based on formula below 80 and positive correction based on different formula above 180.

    I guess the point I'm getting to is that you probably will need to treat food differently throughout the day based on body needs.
     
  7. Heather(CA)

    Heather(CA) Approved members

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    It's true sometimes with the Lantus that it drops them at night. Only with about 20% though, and if that's not the problem, IMHO, it's easier to adjust when you give it at night...:cwds:
     
  8. Mommaof7

    Mommaof7 Approved members

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    See for us, Lantus at night took him from numbers that ranged from 110 -160 to numbers like 49-85, so the nighttime was huge for us, he would go low more than once.
     
  9. Nancy in VA

    Nancy in VA Approved members

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    We go low often on Lantus with a dinner time dose. I'm just trying to get a good dinner time BG reading with a controlled meal so I can skip the dinnertime dose and move it to breakfast - I just don't want to do it when she's high or we're uncertain of her food.
     

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