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How long after an illness?

Discussion in 'Parents of Children with Type 1' started by MikailasMom, Sep 28, 2010.

  1. MikailasMom

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    Do insulin needs usually go back to where they were before a child got sick? DD had scarlet fever and has been running at 200% of her normal basal for about 4 days. Her fever is down and her rash is slowly fading but her blood sugar just isnt cooperating (whats new right?). When we try to taper it back down she shoots right back up to the 400's! Can an illness accelerate the beta cell distruction? Any help or advice would surely be appreciated! Thanks guys!

    Candi
     
  2. Becky Stevens mom

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    Glad to hear that Mikaila is starting to feel better. You are absolutely right about viruses and illness causing Beta cell destruction to speed up. That is one reason for the high #s and the stress of the illness itself will cause highs so its kind of a double whammy. Add to that Mikaila's age (fast approaching puberty?) It may take quite a bit of insulin to get through the insulin resistance shes having right now. I remember when Steven was little it seemed that every cold virus was another insult to the remaining Beta cells and his blood sugars would go up after and insulin doses and sometimes the insulin dose would have to stay elevated. Have you spoken to the endo or CDE about this Candi?
     
  3. MikailasMom

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    I have talked to them about her changing needs this week but I forgot to ask about rapid beta cell destruction with illness. At our last visit he said that she would see gradual increases over the next few months to a year as he expects to see the big day quickly approaching. Thanks for your info! (hugs)..ttys!
     
  4. Susanne

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    I have been asking myself the same question for the past few weeks. Sophia had pneumonia and I had to increase to 200% of insulin also. I thought that her beta cells had finally got the big hit and been destroyed (she were diagnosed fall 09 also) but suddenly, 4 weeks after onset of illness, 2 weeks after recovery, she has been low, low, low for days. And today we are now almost back to where we were 4 weeks ago. Go figure!:rolleyes:
     
  5. Lee

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    To put it simply - yes. Usually, when Coco was honeymooning and got sick, her needs would shoot up, like double, and in a few weeks they would level out with her needs staying at about 150%. Now that the honeymoon is over, her needs come back into range pretty quickly.
     
  6. KHM

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    The other problem...

    Huh...I was just going to begin a thread about resuming normal basal rates, too. Lindsay has had a minor respiratory infection: low-grade fever, cough, sore throat. Between her decreased appetite and I suppose the effect of the illness, she's actually had very little insulin: less than 50% of her usual basal and her boluses have had to be decreased because she has been terribly sensitive to insulin.

    So as she is really on the upswing tonight, I'm beginning to wonder how to approach scaling back her basal...we're on MDI so we only have a couple opportunities each day to do that.

    Can you tell this is our first illness since dx? Any advice from the MDI perspective on increasing back to normal? I find myself worried about sending her to school before we have things in hand better...but I definitely don't want her out of school one moment more than is needed.
     
  7. MikailasMom

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    We noticed that about a week before the big whammy she was dropping like a stone throughout the day so we reduced basals and went from 1:8 carb ratios to 1:15 just to keep her above 100 throughout the day and giving uncovered snacks before bed..it was the strangest thing...then when she started actually running a fever ect she shot way up in the 4-500 range so I spent alot of time un-fixing her dosing back to where it was b4 the wierd week of lows and doubling the basal after that and lowering her back to pre-low i:c. By leaving her at 200% basal she will stay in close to range #'s..until she takes her steroid pill :( then she shoots right back up..sometimes..so frustrated! I cant wait till this is over! This is our first serious illness since dx also, ER wanted to keep her but they are not very well versed in D, esp in kids so I opted to take care of it at home unless it became more than I could handle (had endo office on the phone ALOT and she preferred it that way also) (thier office and childrens hospital is about 3 hours away so in the thick of things we talked almost every hour just in case I needed reinforcements we could head out)...anyhoo..it was quite an experience..very glad we only had moderate ketones 2x and quickly came back down.

    Just also wanted to say thanks for the FB and phone support from the ladies here..you guys were life savers! (cherry flavored even) :)
     
  8. Becky Stevens mom

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    If it looks like her #s are starting to creep up again I would give more lantus every 2 days until she is back up to the starting amount then work on bolus insulin when her appetite is back to normal too. Ive found that this happens if Steven has a stomach bug and isnt digesting food as well.
     
  9. KHM

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    That's very helpful; thanks. She woke up at the top of her range this morning so i do think we need to begin increasing now.
     
  10. KHM

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    What Next?

    Its been a few days; much has happened. We eventually ended up exceeding our usual basal/bolus rates. We haven't seen any ketones in a couple days and although we're still not getting predictable results, we're less wrong most of the time. We're at about 150% of both basal and bolus insulin; correction factors seem variable. I feel like I'm back in chemistry lab titrating stuff drop by drop...

    At any rate, she's back to school tomorrow and I'm not at all certain I know how much insulin she should have for her AM basal or what I:C ratios to use. She's had a couple of lows today (one in the wee hours, one mid-afternoon) and I've not been able to tell if they were because her basal is very high relative to what she was taking 10 days ago or because she had a correction 3 hours earlier that might have been too much.

    I need to know what to tell the RN at school about lunch insulin and I'm thinking that she probably needs to have her blood glucose checked more frequently than we typically do; we've been checking her per 2 hours for the last several days at my endo's request. Given that we've found readings of 55 or less I don't really think we can go without testing frequently. WWYD?
     
  11. Heather(CA)

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    I put everything back at the first low...:cwds:

    For us getting well is a sudden thing, Seth will have a low, I put everything back, and all is good :)
     
  12. Becky Stevens mom

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    Yeah I would test frequently and reduce boluses if shes having some lows now. If her wake up # is ok you can leave basals alone for now
     

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