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Highs at night

Discussion in 'Parents of Children with Type 1' started by MichelleDeGoede, Feb 10, 2009.

  1. MichelleDeGoede

    MichelleDeGoede Approved members

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    My son has been pumping since Oct. and the in last month or so he goes to bed in the 150's, and two hours later he's 300-400. He has a glass of milk, but we bolus for that (and tried without milk) He still goes high at night. I correct him down @ 10:00 and again at 1:00. He is in normal range then by morning. We have changes his basel many times and it doen't seem to help.
     
  2. Sarah Maddie's Mom

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    I think if he's going high at night and responding to the corrections you are giving then it really looks as though his basals are just too low at night. I know you note that you've changed them, but obviously it's not been enough. If he was dxd last fall then he may just be coming out of honeymoon and needing much more insulin at night that he has in the past. What does your CDE say?
    Also, what happens if you ditch the milk? Could your bolus ratio for that be off?
     
  3. MichelleDeGoede

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    We tried ditching the milk, still high. Also if he has milk during the day it does not bring him high. I just changed his basel again so we'll see. We go to the endo March 2.
     
  4. linda

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    Do you have a good repor with Endo? Do you have a ped endo, or just pediatrician?..Only asking because have found some new dxd have to wait so long for Ped endo, they sometimes stay with regular ped for a while.

    I agree the night basels may need tweak, what about bed time carb ratio?

    There are also other phenominons(sp:eek:) that can occur at night...look in the Pink Panther Book...

    Em 1st time since dxd...4 years ago, has started this, so we put the basel from 10:00pm-2am back from .5 to .6 this seems to help, but we may now have to increase carbs we usually only 1/2 bolus night snacks, due to lows, but this is suddenly changing (hormones/ weight gain?)
     
  5. linda

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    Please dont stop your young son from having his snack, its more a matter of finding the correct coverage, especially after an active day! You have to consider the entire day each day, when making tweaks.
     
  6. MichelleDeGoede

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    We have an awesome endo @ children's hospital, I faxe b/s bi-weekly- they say not enough of a pattern to do any changes. Carb ratio has also been changed recently. He is growing everyday and eats like a horse- maybe growth spurt. I'll look in the pink panther book- thanks for your replies.
     
  7. linda

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    Sounds like you have a great plan...Its frustrating, especially as they grow and change, but I would think if high consistantly at night..that is a pattern?
     
  8. MamaC

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    It's also entirely possible that he responds to the insulin differently at different times of day.

    Tom needs WAY more insulin at night than he does during the day.
     
  9. Sarah Maddie's Mom

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    Maddie too. :cwds:
     
  10. Heather(CA)

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    How long after his last shot is he 150? I would do some extra testing to make sure he's not dropping before going high...That is a fast climb, it could be he needs more basel, he's getting to much insulin for the milk, or not enough. With what your describing, I would be worried that he's rebounding...For Seth milk doesn't work the same as food, he needs less insulin for milk.
     
  11. Heather(CA)

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    Seth needs a LOT in the morning, the least at lunch, but not much more than lunch at dinner...:cwds:
     
  12. wilf

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    You don't want to schlepp this along till March..

    How big a change in basal have you made so far?
     
  13. MichelleDeGoede

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    His basel was changed from .125 to .200 from 7:30pm (bedtime) to 12:00am
    Did not seem to make any difference. I'm going to bump it up to .225 tonight to see if that helps.
     
  14. mmgirls

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    my 35lbs 4 yr old has a basal of .275 from 10pm to 3am. she started to spike as you are discribing and AFTER i ruled out a rebound i started to bump up basal. I may need to increase again.
     
  15. wilf

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    That is a significant increase - it could well be the beginning of the end of the honeymoon period. If you like, I'll crunch some numbers to see..

    What is his TDD (total of all basal and bolus insulin per day)? And how much does he weigh?
     
  16. MichelleDeGoede

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    His basel rate is 3.4 daily and bolus is b/t 8-12 units. He was just in his peds office for a check-up. 53lbs and 46" tall. I appreciate everyones help.
     
  17. MichelleDeGoede

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    What do you mean by rebound?
     
  18. saxmaniac

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    A high that comes after an undetected low, as the body floods itself with glucose to protect the brain.
     
  19. Isabelle's Mom

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    DD's numbers also go way up at bedtime. I give her a full unit as soon as she falls asleep. I've charted her food, exercise, and other factors, and finally realized that this increase in bg has nothing to do with food and is probably hormonal. It does not happen at all if she takes a nap in the afternoon. My endo agrees.

    Maybe you are seeing the same thing?
     
  20. hawkeyegirl

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    My son is very close to your son's size - 52 lbs. and 47 1/2 inches tall. His daily basal rate is about 8.2 units, so you very well may be seeing the end of the honeymoon. Jack's rates are highest in the very time period you are seeing highs - between 0.4 and 0.5 per hour. (Contrast that with the early morning where his rates go down to 0.15 per hour.)

    Obviously all kids are different, but I posted Jack's rates just so you could see that it wouldn't be that much out of the norm for a kid your son's size to need quite a bit more basal at that time.
     

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