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i am at my wits end

Discussion in 'Parents of Children with Type 1' started by shirley83006, Apr 9, 2011.

  1. shirley83006

    shirley83006 Approved members

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    :confused::mad: My daughter is about 12 and i know she is dealing with hormones, and for a while now she has been having high numbers, last thursday since she was having the high numbers i had her check her ketones, well it was moderate. I had her drink water, water, water, and gave corrections every two hours, numbers were alittle lower but not enough, and checked ketones again and it was small, and then nothing, great!! but her numbers i cannot get them down. I had even upped her dose of lantus, and now giving her 1 unit per @carbs, and sugars, and still not enough and i told her to change her injection site around. oh and changed the insulin thinking that the one was bad. but last night again, number was in the 300's and i gave her a few units to help bring it down while she slept. At night i am always cautious of how much to give her , i am always afraid to give her too much. this morning it was in the 400's WHAT IN THE HECK ! is going on with her. Could it be hormones? and any suggestions on what i should try???? HELP!
     
  2. mocha

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    It could be hormones, stress, or some bug. :( You sound like you've changed everything to make sure it's not the supplies.

    All I can say is, keep doing what you've been doing. I do the same thing for stubborn highs. Sometimes it just takes a while to get them to come back down (yes, even days), and those are the times when diabetes is totally just being a brat.
     
  3. mmgirls

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    what is her weight and lantus amount an TDD?

    I want to say due to age and the ketones that most likely she need a big jump in basal insulin or maybe twice daily lantus.

    I say that with respect to that you say it has been going on for awhile and already changing her I:C (did i read that correctly you are to a 1:1 ratio) she is still having ketones but is otherwise not sick.

    there always seems to be that tipping point for us when we change the I:C and ISF and get results but then we get too heavily that way and are constantly correcting. And have to go back to the drawing board.
     
  4. hawkeyegirl

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    Whenever we see constant highs, we have to keep increasing basal until corrections start working. Usually once we get him down, we have to lower basal back to just above where we started.

    Ratios and corrections will not work until you get basal high enough.
     
  5. skimom

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    Just another thought - are you sure that all food is being accounted for ( ie no sneaking of food is happening)...
     
  6. swimmom

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    We've had to increase all basals for my 12 year old a couple of times now. Things seem to be going well and then bam!! unexplained highs all day & night. I watch for a couple of days to make sure it's a pattern, then up the basals again. Then test like crazy all night because I'm afraid of lows. Maybe it's a little easier on a pump because I can up the basals in 3 hour increments or whatever seems best and try out temp basals. I wouldn't know how to manage that with Lantus. It's definitely adding to my gray hair count.

    Our endo likened the hormonal surges to hot flashes in menopause. They aren't gradual and steady, the hormones come in bursts and waves.
     
  7. caspi

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    While I am dealing with a boy and not a girl, we are dealing with the same thing. First he was crazy high, we upped his lantus and things were great for about a month. Then the lows started. Scary lows! So we lowered the lantus back down. The joys of this rollercoaster called puberty and diabetes.... :rolleyes:
     
  8. somanybakers

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    I would consider a possible pump issue. Lucas was consistantly high for a while. We were fighting high #s for more than a week using lots of corrections and upping basal. When we went to change the resevoir the pin would not stop when priming. We switched to MDI (at his request for many reasons) and called Medtronic who replaced it. I suspect there was a malfunction going on the whole time because with injections his numbers settled right down. Just a thought.
     
  9. caspi

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    The OP is on MDI, I believe....
     
  10. mom24grlz

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    we're dealing with craziness too, only ours is the opposite: lows. Well let's see last month we dealt with higher numbers this month it's lower numbers. I've lowered her basal and her I:C and most of her BS are still around 70.
     
  11. caspi

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    That was our issue as well. I can understand if the lows were caused by increased exercise, etc. but there was absolutely no rhyme or reason to it!
     
  12. kk4jbird

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    Highs & Ketones

    For testing ketones I hate the urine strips as there can still be ketones in the urine 2 hours after they are under control or may not show up in the urine right away. I use a Precision Xtra blood ketone meter. It measures the ketones in decimals so it's more precise. And then we have dosing guidelines of % of TDD depending on what ketone range the reading falls into. I can do a BG check in 75 minutes (we use Apidra) and see an immediate reduction to know that we are on track. I feel like it gives me the best most accurate info for especially when he is sick.

    http://www.abbottdiabetescare.com/precision-xtra-blood-ketone-test-strips-en.html

    http://www.childrenwithdiabetes.com/d_0i_191.htm
     
    Last edited: Apr 9, 2011
  13. somanybakers

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    I'm sorry! Your right, upon rereading I see that the OP's child is MDI not a pump. What was i thinking?:confused:
     
  14. Darryl

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    It really sounds like growth hormone (GH is secreted irregularly and causes the liver to produce glucose into the blood while at the same time causing the body to become insulin resistant, resulting in persistent highs). We've had virtually the same experience since dd was around 11-1/2. Her IC ratio is now 1:5 and on some days (or parts of some days) she needs unbelievably high basal rates, as much as 8u/hr, alternating with days (or parts of days) with basal needs as low as 0.5u/hr. The answer is to constantly adjust the basal and/or give frequent insulin and carb corrections, which requires frequent testing if you're not using a CGM. But what you're seeing is normal at this age.
     
  15. wilf

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    Were you meaning to say she's getting 1 unit per 2 carbs?! :eek:

    If so then she is getting too much insulin. You may be dealing with a vicious cycle of lows and rebounds.

    We need some more info here please. Regarding her Lantus, how many units is she getting at what time each day?

    And what was her TDD the last 2 days?
     
  16. melissajm

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    Ben is 13 and we were just dealing with the same thing...
    highs for almost 2 weeks before we made all the correct adjustments.
    We increased his Lantus by 1 unit and eventually changed
    all of his I:C ratios. I really think it is the age!!
     
  17. dqmomof3

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    If she hasn't already, I would bet it means that she's going to start her period sometime in the next few months. We went through the same thing...constant highs, constant adjustments, constant wishing my daughter wasn't allergic to the CGM sensor and Apidra so that I could have both and gotten some help!!

    And then she started her period. It was as if a relief valve was opened...not that we don't see any highs, but they are nothing like what we were dealing with before. Her A1C for that six month period was 9.9%...highest it's ever been.

    Do your best...at one point we simply doubled every amount of insulin she was on, and kept going up until we actually started to get some lows. Then I adjusted back the other way. Someone here...I believe it was saxmaniac (aka Scott) said that's what he calls "rage basal adjustments." That's exactly what it was for me...I was mad that all of my diligent work wasn't paying off. Do what you need to do...insulin is your friend, and you need what you need.

    Fix the basal first, though...the Lantus has to be right before anything else is going to work correctly. Don't be afraid of large doses during this stage...you will need them!
     
  18. shirley83006

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    update, all clear!!

    :)well, days ago i had to call the doctor and they told me exactly what to do. an all clear! no more ketones, and no more crazy numbers. I guess it was stupid hormones, she had this before that lasted a couple of weeks. But now she is sick with the sore throat. ugh. so hopeing that , that will not make things go crazy. So far so good. Anyways, just an update on how she is doing. Thanks everyone for being there!!:)
     

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