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Issues with how quickly, or slowly, insulin works

Discussion in 'Parents of Children with Type 1' started by Schleprock, Feb 10, 2014.

  1. Schleprock

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    I posted this on another site and am hoping to get more input here,

    My son (age 11) has been type 1 for almost 10 years now.

    He has major issues with how quickly, or slowly, insulin works in his body. I see other posts about high spikes and his is just over the top and they take so long to come down, then by the time the insulin starts working he is hungry again so his BG is constantly staying high.

    We have tried Humalog, Apidra, and Novolog but it never seemed to make much difference.

    It takes his body 2 hours from bolus or injection time before his blood sugar levels start coming down. Regardless of how or where the insulin is given, it just NEVER makes a difference.

    To make matters more complicated he has an insatiable appetite. I used to think it was because of a growth spurt or illness but he has been this way for years.
    I can not express how big of an appetite he has, he is ALWAYS hungry! He eats more than a grown man for crying out loud! And seems to never get full. He is not real skinny but not overweight in the least.

    I am at a loss. His A1C's are always too high and it is understandable to me because he is always eating and then insulin takes forever to work in his body.
    Is 2 hours a super long time to BEGIN bringing his BG down?
    My sister is type 1 for over 30 years and she said hers starts coming down within 15-20 minutes
    .

    Has anyone ever experienced these problems?
    I feel like we are so alone with these issues and I feel the doctors do not understand.

    I am hoping someone may have some advice.
     
  2. Schleprock

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    Need to add that he has ALWAYS had the slow insulin action time! So this isn't a new problem but it has never been addressed by the endo even though I have told them several times.
     
  3. Christopher

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    So this is the same problem you had 5 years ago. Did you try any of the advice given you back then? Did you try pre-bolusing? Did you talk to his Endo? Tried a different Endo? What have you done in the past 5 years to try and address this?
     
  4. MomofSweetOne

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    Have you tested his basals? If the basal insulin isn't correct, then the bolus insulin ends up not working to bring the BGs back down.

    If he's snacking all the time, then you may need higher basals to compensate for it as well. Do you have different settings for school days and weekends?

    If he's 11, adjusting basals often will become important to keep up with his changing insulin needs.
     
    Last edited: Feb 10, 2014
  5. hawkeyegirl

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    My instinct is to increase his basal during the daytime hours.
     
  6. mmgirls

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    I would say that basal is way off and what you think you are dosing for meal/correction s actually covering basal needs. If you are giving huge boluses and he is coming down quickly he actually might be feeling low even though he is no where being low because his body has been to used to the higher BGs. If he is "feeling" low he may eat more to conter the feeling, although I do beleive that it is pretty normal for an 11 year old to eat every 2-4 hours.

    At this point you probably need a new team to help you get thru this beofre puberty starts.
     
  7. Schleprock

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    Thank you mmgirls! I think you are spot on!
    I always put my trust in the endo team and I feel we are both frustrated. I had accepted that this was just the way my son's diabetes is but I also think that he can not be the only one having these issues and surely someone somewhere has it figured out.
    We have an appointment tomorrow and I am going to bring this up (again) and insist that there has to be something we can do to help him attain better blood sugar levels.
     
  8. Schleprock

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    This is the third time you have replied to one of my posts and instead of offfering advice or understanding you always seem to make some sort of accusatory remark and it is not appreciated.
     
  9. Christopher

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    It was not meant to be accusatory. I was simply asking what you have done, since this is the same issue you were having 5 years ago. Based on what you have or have not tried, people can better be able to help you. People here have spent time giving you a lot of advice about this issue and other issues you have raised. I was just curious if you ever act on the advice you are given.
     
  10. nebby3

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    I agree with upping the basals a lot, even if it seems like more basal than he should need. It sounds like he eats frequently so you should have no problems getting him to eat when he needs to.
     
  11. Sarah Maddie's Mom

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    Your endo team has let this go on for years without making basal changes or suggesting that you do so? If that's the case then why are you still with them?
     
  12. kiwikid

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    I agree entirely with the insatiable eating causing high bg's. This is one of my favourite articles about it : http://diatribe.us/issues/41/thinking-like-a-pancreas.. I tend to over basal to compensate because I would rather feed a low than chase a resistant high. Trying to find a low carb, filling, appetising food for preteens/teens is near impossible.. What is your DIA set at?
     
  13. Amy C.

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    When my son ate all the time, he upped the basals a bunch to help with the spikes. Only works if he always eats all the time.
     
  14. Junosmom

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    Thank you for the link to the article. This is something I'm contemplating right now. My 11 yo son will want to eat before the last eating "cycle" is complete. I've been reading on this forum and from Scheiner that a 50/50 basal/bolus is a goal, but we are at 25/75. I'm thinking his basal is too low, especially since he's grown 1.5 inches since diagnosis and is likely no longer honeymooning - or is coming out of it. He no longer returns to an in-range number after his bedtime snack, so I'm going to work on basal.

    Endo office otherwise top notch but I don't think are aggressive enough in teaching us to eliminate peaks, stay in range. Have to learn by reading here :)
    There is only one other endo choice, had her for my daughter, and don't appreciate her approach.

    Anyway, this was timely. I'm trying to eliminate a pesky night high after midnight, but I think it is an overall problem of always being high and low basals. Now, a basal test requires fasting?? Or just keep adjusting up until it is better? How to find the right level while feeding a hungry 11 yo?
     
  15. Sarah Maddie's Mom

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    Basal testing means no carbs and ideally very little food. It can be tricky to say the least. '-) I think it's easier for most kids to break it into segments - like if he sleeps late on the weekend and then you stall on breakfast you can sneak an AM basal test right in without him ever noticing. In 11 years we've never done more than 5-6 hours at a time.

    And I wouldn't write off your son's honeymoon just yet. ;-)
     
  16. nebby3

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    I am not sure basal testing is all that useful if you have a grazer (most teens it seems). I prefer to run basals high to help stop spikes if I know my dd will want to eat frequently. I am also skeptical of the 50/50 rule. It isa theory but may not fit your kid. Again with a grazer I'd expect to see more than 50% basal.
     
  17. wilf

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    You're using a pump, so you have options. Try doubling basals during the day on a weekend when he's at home, and see what happens. :)
     
  18. Junosmom

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    Thanks, Wilf. My nervousness is in how much and when :) I'm going to try it though. He's homeschooled, and I work weekends, so we are going to try tonight. Last night, I didn't do anything because Monday is tae kwon do day, and he sometimes goes low at night. Not last night - woke up to check at 3 a.m. and he was 191. Same pattern - starts dropping after bedtime snack and then around midnight, goes high. I think my boy is growing. Measured 1.5" growth yesterday morning since September.

    Thanks for support.
     
  19. Junosmom

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    Okay, that helps - I'll try the higher basals. So you'd do more than 50% with a grazer? We are moving towards grazing even more as he grows.
     
  20. Junosmom

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    I'm going to try to increase tonight, and then try a sleep in for Thursday morning. (I have to tutor kids tomorrow morning.)
     

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