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Need help with Type 1 Daughter

Discussion in 'Parents of Teens' started by demopls06, Oct 29, 2010.

  1. demopls06

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    Need help with Type 1 Daughter

    Were only about 3 months into this.At first my daughters numbers were great but over the last 2 weeks her #'s have been running in the 200 + and I can't seem to get her to understand the importance of getting her #'s in control and it's driving me crazy.When she was first dx they gave her the amount of carbs she should be eating for each meal and snack based on her lifestyle. Breakfast 70 lunch and dinner 75 snack 15.A few weeks ago she started talking to another type 1 at her school and this kids is always in the 2 to 300 range and eats a lot more carbs.Come to find out shes been eating 90-100 carbs per each meal(she is covering for carbs) Could her being inactive with that amount of carbs cause her to run high because she not burning off the carbs? I have started making her write everything down again because she upped her carbs by herself.I became lenient because she was doing so good and I thought she understood the importance of good control.She's 15 in the right weight category just inactive.Can't get her to exercise at all even though the few times I could get her to it helped and she knows it.So any input would help
     
  2. Amy C.

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    If she is giving herself more insulin for the extra food, it sounds like she may not be doing quite enough extra insulin. In theory, what it appears she is doing should work. One doesn't need to eat a certain amount at each meal to keep the blood sugar in control.

    Which insulin regime is she on? I assume she is counting carbohydrates and has a ratio of insulin to carbs to determine how much insulin to give.

    An effect of eating more along with the appropriate amount of insulin is to gain weight.
     
  3. Lisa P.

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    At three months it's time to go see the endo anyway, so ask to sit down with a CDE and get a new plan. Doctors usually start you off slow and then once you understand carb counting and are feeling better they move you to a more complicated routine that allows for more flexibility, like the other child has. She can have that, but she has to reach it in the proper way.

    Also, there is a honeymoon stage in Type 1 where the diabetic child still has a few active islet cells producing a tiny bit of insulin. When she starts getting treated, those cells get a breather from the stress they've been under and start producing some again for awhile, and that keeps numbers more even. Once those cells, unfortunately, get destroyed also, it's harder to keep numbers in range. So the raise in your daughter's numbers might have nothing whatsoever to do with her choices, it's just the way things are progressing and you need together to adjust for it.

    Best to you.
     
  4. demopls06

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    Her insulin carb ratio Is 1unit per 10g carbs.She is on Humalog and Lantus.I was just wondering with her inactivity with the higher amount of carbs that she probably isn't using would cause her to spike?So far she sees her endo monthly her next appt. is in Nov.As for the honeymoon stage they told me she probably wouldn't have one because her Pancreas took a big hit when she was fist DX she had severe Pancreatitis DKA and extremely high triglycerides (19,400) which she needed plasma pheresis for.
     
  5. Jacob'sDad

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    If she was on a fixed amount of carbs and then after increasing the carbs and taking the appropriate increase in insulin, she STILL goes high, it could be showing and underlying basal/carb ratio issue.

    Think of it this way taking breakfast as an example:
    The amount of insulin she gets from breakfast to lunch is a combination of bolus and basal and at 70 to 75g of carbs, that combination worked pretty well for her. It doesn't mean that either her carb ratio or her basal were right on. It just means that between the two, it was the right amount of insulin.
    Now she has increased the amount of carbs she is eating. I hope she is bolusing for those extra carbs. I will assume she is. Let's say her basal was on the high side, meaning she was getting too much basal insulin, and her carb ratio was giving her too little bolus for the food, but between the two, they canceled out. Now with increased carbs she might be getting significantly too little bolus for the food because the carb ratio is off. You didn't see it with the carbs being a fixed amount, but now you do.

    Or it could be that she's just growing and dealing with hormones.

    In any case, I doubt that you will be able to keep her on fixed carbs forever. No doubt, varying the carb amount makes things more complicated, but in reality, most type 1s vary their carb intake. She can learn how to make adjustments for it now, with your help, or she can figure it out on her own either now, or when she is an adult. The more the two of you are on the same page, and the more you work together, the better.
     
  6. Amy C.

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    Is she high all the time or only an hour or two after a meal?

    Spiking after a meal is quite common. This is a problem of timing -- the food is digested and raises the blood sugar before the insulin can kick in to keep it lower. Many resolve this by giving the insulin 15-20 minutes before the meal.
     
  7. Lisa P.

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    Yes and no.

    There's not doubt that my kid has a more even bg when she is active and eating complex carbs at lower (not low) levels in combination with proteins and fats. But those things can also make a roller coaster happen -- she goes low from exercise and rebounds high (e.g. if she's swimming she can bounce from 70 to 300 and back in far less than an hour), or fat delays absorption too much and she goes low, and then she gets a fat spike later.

    I think all of us here in the months after diagnosis had to come to peace with the variability of diabetes. Maybe you've got that internalized already, but it took me nearly a year to really "get it" that highs and lows and spikes can happen for many, many reasons. If you think activity levels are a big part of that, you may well be right, but there are so many factors that could be causing her to spike that I'd take it slow and work with someone looking at a logbook of her numbers for a week or so to take in all the factors.
    Thing is, if you make it about her inactivity and then find out it's because her basal insulin is set wrong, or her ratio is off, or she's actually going low and rebounding, that's going to be tough for helping her later with her management.

    Plus, if she's in school full time and eating in the cafeteria, she has limited choices on how active she is and what she eats, daily. Ninety carbs at a meal seems mind-boggling to me, it would send my kid's bg to the moon, but lots of kids here do that and more with no problems at all. It all really depends.

    So, yes, you remind me I've got to get my kid up and running more (we're supposed to go walking today, think I'll get my sorry tush out the door? :eek::p). It does make a difference. But in trying to answer your question, I'd have to say a definite maybe but also a certain maybe not, so much. :eek::D

    Have a great day.
     
  8. demopls06

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    Thank You everyone for the input.I think we'll try giving the insulin 15-20 min before meal and see how that works.They told us to give insulin right before meal they said nothing about waiting 15-20 min though.:)
     
  9. Lee

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    Does exercise and extra carbs play into a higher blood sugar- yes and no...it plays more into an unhealthy lifestyle and less into a an unhealthy bs.

    Fact of the matter is, your Dteam should be helping you and your daughter work together to increase insulin amounts. She will constantly be changing her dosage amounts probably until she is an adult and has less growth hormone, but as a girl, she will always also have spikes and drops due to her period as well.

    Carbs are only on small part of the big D picture. By placing all the blame on carbs and lack of exercise, you are in fact blaming your daughter for not taking care of herself. She has all of her life to play the blame game, and to feel guilt about every blood sugar reading. Try instead to see the number as a number and disassociate from your daughter. It is really hard to do, but judging the number, and the role she plays in it, places ALOT of guilt on ehr shoulders and honestly, you and she will never ALWAYS be able to find a cause for highs and lows...so you gotta take the #, and deal with the number and that number alone. If you see a pattern of that higher or lower #, then you have to adjust one of her two insulins to deal with that #.

    I also recommend Kerri's Blog - http://www.sixuntilme.com/

    Read some of her past blogs - it talks alot about guilt and #'s, hormones and #'s, etc, etc, etc. She really does a nice job of giving us mom's and dad's an idea of what girls really go through with Type 1.

    Good luck, hang in there, it totally sucks, but it does truly get better - I promise!
     
  10. KRenee

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    You might also check on what exactly she learned from this friend...if a diabetic runs a higher BG they will lose weight, which is why most kids lose weight before diagnosis. Make sure she didn't learn anything undesirable.
     
  11. Lee

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    Very good point Karen!
     
  12. wilf

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    She is not high because she's eating too much. She's not high because she's not active enough. Please try to get these judgmental-sounding thoughts out of your head as quickly as you can. They can be incredibly damaging to your daughter's development and to your relationship with her.

    The simple reason your daughter is high is that she's not getting enough insulin.

    It seems bizarre that in 2010 your daughter has been put on a fixed number of carbs per meal. That's how diabetes was managed 30 years ago. There are simple formulas for calculating how much insulin she needs to cover whatever amounts of carbs she eats. Get your medical team to teach you these, or learn them yourself.

    There are excellent reference books out there:
    - Type 1 Diabetes by Ragnar Hanas
    - Using Insulin by John Walsh
    - Think Like a Pancreas by Gary Scheiner

    Teens are hungry all the time. Their bodies are growing and developing. Your job is to help find the appropriate carb ratios and correction factors to allow her to cover the carbs she wants to eat with adequate insulin. You have your job cut out for you.. :cwds:
     
    Last edited: Oct 30, 2010
  13. Sarah Maddie's Mom

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    I think you are confusing general healthy life style choices with good D management. Your daughter needs to cover the carbs she eats with insulin. The question of how many grams of carbs she should be eating and how much she should be exercising should be determined based on her overall health and not strictly in relation to how much insulin it takes to cover those carbs.

    I have to agree with Wilf, the tone of judgment is pretty strong in this post, and it's not a healthy attitude for your daughter to be hearing as she begins to adapt to this new chronic illness.
     
  14. Marcia

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    Before diagnosis, our kids were literally starving and it isn't unusual to hear stories of increased appetite after diagnosis. Your daughter needs to be on a different insulin regime, not on a fixed carb at meals. Teens are growing and need extra calories, food is also tied to social activities. I would suggest at the next endo appointment to ask about a change from fixed carbs. This is a time to be your daughter's advocate.
     
  15. SunnyReid

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    When you are first diagnosed the educators and medical team teach you how to look after diabetes, not live it. It does take time. And i know that hearing that makes it hard as we all want our kids ot be in range 24/7 but this i not going to happen. My 10yo DD is already showing signs or puberty and this is a tough time as it is without diabetes in the mix. Just a tip I got from someone else, make a note of her periods against her BGL.. this can make a differance with PMS and the actualy bleeding days.
     
  16. demopls06

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    Thanks for the beat down .Nice to know everyone is so quick to judge me.I am just concerned for my daughters health I am not standing over her screaming she's a horrible person I am just scared to death for her health after reading many horror stories about poor diabetes control.I was told this was a good place to post for advice(no judgement)I definetly wont be posting here anymore for advice.Thank you so much
     
  17. Christopher

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    I thought you got some very good advice above. Sorry some of the comments upset you. But for what it is worth, I didn't find any problem with your original post. However, this is an open forum and you are going to get all kinds of responses, take the ones you feel are useful and ignore the ignorant ones. If you take that advice, you will find that this is a great site for support and information.
     
    Last edited: Nov 17, 2010

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