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More than 100% insulin increase in 30 days

Discussion in 'Parents of Children with Type 1' started by njswede, Feb 15, 2016.

  1. njswede

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    Took a look at his insulin trend. 13U/day to 28U/day in 30 days. No wonder it feels like we're playing a futile game of catch-up! He's creeping up towards 1U/day*kg. Any suggestions other than holding on to our hats and riding along?

    insulin_trend.jpg
     
  2. Theo's dad Joe

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    Almost in the exact same boat here. We were at around 12.5 per day 30 days ago and around 22 now. Basal up from 4 to 8. Our carb ratios have dropped even more but it may be partly a basal problem.

    Curious what is your correction factor per unit and about how many carbs are you averaging per day? I have become concerned that my son's higher fat diet has made him less sensitive to insulin, however he remains very sensitive to corrections (around 100 to 1) and low fat meals still require as much insulin. I was hoping we would reach some plateau for a couple of weeks. He has also been mildly ill (cough, cold but not flu) on and off for a couple of weeks, so maybe that is contributing. If he had grown more in the last 6 months I'd feel better. He's up 1.5 kilos which is still pretty good for 6 months.
     
  3. wilf

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    Looks like not enough basal to me.
     
  4. njswede

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    I think you're right. We're at about 30/70 now. Want to get closer to 40/60. We're going to tweak it little by little until we get there.
     
  5. andiej

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    I'm guessing the honeymoon is on it's way out. We saw something very similar when the honeymoon came to an end...In the december he was on 12 TDD By January 25 TDD a few months later 40 - 50 TDD....it sure was a crazy time. Just keep going you'll get there eventually. good luck.
     
  6. rgcainmd

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    The closer I tweak my daughter's basal to bolus to 50/50, the less TDD she ends up needing. But, as always, YDMV!
     
  7. njswede

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    I jacked him up to 9.5U/day basal today. It's hard to believe he was running on 0.5U Lantus 10 months ago!
     
  8. rgcainmd

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    They do grow quickly, don't they? And with them, their insulin requirements... My daughter went from about 13 TDD to around 28 TDD over the course of about 3 to 4 days, if memory serves. She's now at about 70 to 75 TDD (and climbing!) I'm looking forward to her adulthood (if I'm still around by then) when TDD is supposed to level off and decrease.
     
    Last edited: Feb 17, 2016
  9. njswede

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    Yeah, he's in a phase right now when he's ALWAYS hungry. He eats faster than we can make him food. No, I don't think it's D-related. He's just growing. And it's mostly bones and muscles.

    But dosing insulin for a kid who's constantly eating isn't easy. Can't wait for the teenage years when this goes into overdrive... :)
     
  10. KHS22

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    Honestly, we've had this happen a couple times, up doses, up doses etc. Then a few weeks or month later, LOW LOW LOW and decreasing doses decreasing doses etc. I try to explain it (growing, sick, change in routine etc), but half the time I can't. I've just accepted this as part of the roller coaster… LOL
     
  11. njswede

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    Yeah, life with D has its ups and downs. Very literally!
     
  12. rgcainmd

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    Your post reminds me of something I heard recently:

    During one of Gary Scheiner's wonderful live webcast interviews, a parent typed in a question for him, something along the lines of "My child has Type 1 and their BG is doing this, and I tried this, and then their BG did that, then I tried this and then their BG did this (etc.) What do you think is causing this?" Gary's answer: "It sounds to me like your child has Type 1 Diabetes."
     
  13. msschiel

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    We have been dealing with the same thing. Just upped some basals last week and had to up them again yesterday. I didn't check his basal/bolus ratios, but he was high most of the day today. Had a site change, so we shall see what tonight's numbers are. I think he is growing again. He will be 13 next month.
     
  14. dpr

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    This is us^^^ our basal doubles and halves every 2 to 3 months. Our endo thinks it's beta cell regenation but I have no idea other than just hold on for the ride.

    Njswede, as far as basal/bolus percentage don't worry about it just go for the flattest line. Some CDE's get all wadded up over that ratio but the flattest line speaks the truth.
     
  15. KHS22

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    Ha. Awesome.

    And nice to hear others go through this too dpr!!!
     
  16. scarral

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    Hi, I'm new to the forum. My first question: what's TDD?
     
  17. njswede

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    Total Daily Dose, i.e. all the basal and bolus summed up over 24 hours. A rule of thumb is that someone who's out of honeymoon should get somewhere between 0.5-1.0U/day per kg of body weight. So if you weigh 30kg (about 70 lbs), you should need somewhere around 15-30U/day. That varies widely based on your diet, your activity level and a bunch of other factors, of course.
     
  18. scarral

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    Interesting. My almost 4yo ds was diagnosed in October, we have the medtronic 640g pump and sensor with smart guard. He weighs 16kg and takes about 10 IU per day, which is 0.6 units per kg. 75% of that are Bolus insulin. Does that mean he's not in the honeymoon phase anymore?
     
  19. Mimikins

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    I'm having the exact same issues. TDD went from 15-17.5 units/day and is now hovering around 25-32. I woke up super high on Monday morning, and the past three days have been spent trying to figure out new strategies for dealing with and preventing the highs (currently chilling out with a 230% temp basal with an ISF that's acting more like 1:20-30 instead of my usual 1:80. I haven't even started to figure out a makeshift I:C). Keeping my fingers crossed this is only a temporary phase, but I'm starting to think that whatever honeymoon/beta cells I had are now starting to give out on me (I had a similar period where my TDD almost doubled less than 3 weeks ago, and I am not experiencing any other signs of infection/other things that can cause my basal needs to skyrocket).
    Diasend TDDJanFeb 2016.jpg

    Edit: And it now looks like my insulin resistance is decreasing. Now I'm dealing with non-stop lows. Gotta love diabetes. :wink:
     
    Last edited: Feb 24, 2016
  20. Theo's dad Joe

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    Does he wake up with good numbers? My son was over 0.5 per kilogram from 6 months to 1 year out, but would wake up for breakfast at 70-100 every morning no matter what, even if he went to bed at 200. I am not even sure if that is typical of a honeymoon. In fact on CGM I could see that he would "fix" a post dinner high by midnight, and usually be around 100.
     

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