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Highs at night

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

  1. wilf

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    It looks to me like he's getting not enough basal, so be brave in gradually raising the amount each day to take care of those night highs.

    His numbers indicate he is just coming out of his honeymoon, so expect insulin needs to go up in fits and starts over the next while.

    Good luck! :)
     
  2. Heather(CA)

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    I'm going to try this again....This was my first post


    The reason I asked when his last fastacting shot was, was to help determine whether he may have had a rebound, or if he just needed more basel...

    For example, if he gets his dinner Bolus at 7, then goes to bed at 150 by 8:30. There is a good chance he's rebounding because he still has insulin on board that could drop him a lot more...

    A rebound is when they have an undetected low, the body responds by shooting out glucose from the liver which makes them high, in the 300+ range. It's a safety net/panic mode.

    On the other hand, if he's gettin ghis last bolus at 6, then not going to bed until 9-9:30 then it's most likely a basel issue since the fastacting is gone.

    I know you are giving milk, but you said this happened even when you didn't give it to him right? So, it's probably not from the milk bolus?

    Rebounds are hard to get down with full corrections, if tghe bg is coming down with a partial correction, or going up with a full correction, these are signs it could be a rebound. I hope this helps...
     
  3. MichelleDeGoede

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    We eat dinner usually 5:30-6:00. He get boulsed then & rechecked around 7:30 b/f bed. I then recheck him around 10:00 b/f I go to bed and he is high. I never heard about rebounding b/f, so I will make sure to check him @ 8:30 also. Thanks for your tips.
     
  4. wilf

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    The 8:30 pm check should resolve this question one way or another - and if it's not rebound, then it's not enough basal..
     
  5. MichelleDeGoede

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    I am going to feel horrible if he is rebounding and I 've been overdoseing him. I'll let you know what the numbers are tonight.
     
  6. Sarah Maddie's Mom

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    No, don't go there yet :cwds: Rebounding happens but I'm betting that it's the basals.;) It sounds like your doing a great job and are very much on top of things.

    Welcome to CWD btw:D
     
  7. mmgirls

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    I think other covered this fairly well.

    I have been tempted to do this, too. As soon as my dd FALLS ASLEEP naps too, she has her RISE. I have just increased basal during the time after she falls asleep and after iob has ended. I sometimes have to give a small correction if she fell asleep early or was not as active for the day.

    I know, this is exactly how I felt a few months back when I learned more about rebounding and corrections that just don't work and staying high at night. But in our case after i ruled out those rebounds i learned that her basal was just not enough to combat those growth hormones that happen when she falls asleep. Correction don't work well if basals are way off too. So don't worry about it until you do some extra testing to verify that rebounds are not happening and that basals need to be bumped up.
     
  8. mmgirls

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    He is getting way more insulin via a bolus that his basal. the honeymoon is probably ending a bit and you have probably been changing his ratios more than his basals?? It might be good idea to try to do some basal testing at some point. You might be able to get a little better control with higher basal rates (if basal testing indicates this) and a higher I:C (less bolus insulin and more basal insulin).

    Recently my dd's basal went from 3.5 basal and I:C's of 1:20 & 1:25 to a basal of 5.25 and ratios of 1:14(morning spike got worse) and 1:30. her tdd has only increased by about 1 unit but i am not seeing as much "yo yo'ing" and less varatability (sp).
     
  9. Heather(CA)

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    The high may or may not be rebound highs, (If Seth was 150 @ an hour and a half at your stage of the game...He definately would have gone low, but YDMV) I would just hate for you to keep upping the basal without knowing for sure...I would test at 8, and 8:30 to see which direction he's headed. If you find out he has been going down, don't beat yourself up, we have all been there and your still learning. Seth has had D for almost 6 years and I still learn things:cwds: Keep us posted, now I'm curious.:cwds:
     
  10. saxmaniac

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    We had this all the time on Lantus. Happens with no dinner at all, he just needs more basal at that point. So we pump now.
     
  11. MichelleDeGoede

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    OK, so this was our last nigh.
    7:20 -BG 104, 2 units IOB (Gave milk w/ no bolus b/c so much IOB)
    8:01-BG 163 (to bed)
    8:49 -BG 288 (sleeping) still .6 IOB
    9:39- BG 381 (corrected down):(
    12:06: BG 294 (corrected again)
    7:00 : BG 212 (ate breakfast)
     
  12. hawkeyegirl

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    I'd say it's a basal issue. You'll have to go a night without giving any milk before bed in order to pinpoint exactly when it happens, but it looks like basal to me.

    Is he getting too much insulin at supper? It looks like that might be an issue as well.
     
  13. Sarah Maddie's Mom

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    At a glance and without knowing what was for dinner and what dose and what number going into dinner, I'd say it looks like dinner dose may be too high, overnight basals too low and correction factor is also off. :cwds:

    I agree with PP that it's hard to tell what's going on with the milk sort of skewing the info.

    Keep us posted. Is CDE seeing these numbers? Are they helpful?
     
  14. Isabelle's Mom

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    Agreed. What time did he eat dinner? The dinner bolus might be too high, as stated in the previous post, or the basal could be too high in the hour or two just before dinner.
     
  15. MichelleDeGoede

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    I'll try no milk tonight and try again. I fax BS everyweek or two for sure. They say not enough of a pattern to make a change. I let you know tomm.
    Thanks for your opinions.
     
  16. Heather(CA)

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    What time was last bolus?
     

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