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Night time numbers question.

Discussion in 'Teens' started by Artgirl, Nov 19, 2015.

  1. Michelle'sMom

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    Oh, in case the numbers are confusing....to convert, divide our BG readings by 18 to convert to yours.
     
  2. wilf

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    This post is disappointing on so many levels. Especially coming from a medical professional.

    First of all, numbers between 4.5 and 10 is the equivalent of numbers between 81 and 180. Pray tell what is wrong with numbers like that?! Those are the range of numbers we all work with - if we're lucky.

    Secondly, we've never had a CGM and have gotten by with mostly one test (occasionally 2) a night - not 4 to 6 - and DD's blood sugars varied by more than Artgirl's. Please don't think or try to imply that your level of paranoia is the standard the others should live by.

    Thirdly, your over the top attacks on Artgirl's endo are unwarranted and unfair. The endo has her on a regimen that is working for her at present (notwithstanding your bizarre comments).

    Artgirl, I just want you to know that we worked with an NPH based regimen for several years and did well with it. It's trickier than other insulins to understand and use, but if you take the time to get to know it then it can work quite well.

    Please don't get discouraged when you get a weird post like the one I'm responding to. There will typically be gems of wisdom in the responses you get, but also some things that are hurtful or not useful. If you can learn to take from the many and varied responses to a thread the information that is useful to you and just ignore the chaff - then you'll find these forums to be an extraordinarily valuable resource. :cwds:
     
    Last edited: Nov 22, 2015
  3. wilf

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    How much does she weigh? Knowing that we can tell you if she's honeymooning - but my guess is she's not.
     
  4. wilf

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    It is not uncommon for kids with Type 1 to have lows before being diagnosed. Our daughter did.
     
  5. rgcainmd

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    Wilf, I wouldn't call numbers that vary from 80 to 180 exactly great in a newly diagnosed kid. At least we didn't have those kinds of numbers after diagnosis. Maybe it was because we had more predictable insulins (Lantus and Humalog) with which to work instead of NPH. Seems like I'm not the only parent who thinks the care Artgirl's daughter is receiving leaves a lot to be desired. And as another parent pointed out, it is inadvisable to inject NPH at night and then not check during the night. Just because you don't use a CGM doesn't mean it isn't helpful for other parents, especially those who do not want to check their children's BG during the night. Here's another case of someone asking for advice (repeatedly) then not liking what they hear. Why even bother asking? You don't know me, so don't be so quick to address my "level of paranoia". Yes, I am a medical professional; once you have had to declare people dead after the medical care they received was sub-standard and their deaths could have been prevented or avoided, then come back here and call me paranoid.
     
  6. Michelle'sMom

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    80 to 180 so soon after dx is fairly common, & it's also a fairly common target range...regardless of insulin regimen.

    The issue I see here, & it's only my humble, non-MD opinion, is that this is a mother who obviously is dealing with the shock & fear of a newly dx'd child. We've all been taught that our medical providers are on some sort of higher ground, & their word is golden. We should trust their knowledge & follow orders. This mother is weighing the advice of a trusted provider against the advice of a group of strangers on the internet. She came here for support & knowledge. How about providing a little more of both of those, & a little less of the criticism, veiled insults & fear-mongering? A little compassion & handholding in the early days can go a lot further than the BS treatment I've seen thrown her way.


    CWD has developed a really negative reputation, & the treatment of new members like Artgirl make it painfully obvious why. Some here seem to have real difficulty with common kindness.
     
  7. sszyszkiewicz

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    Sorry rgcainmd but in this instance your bedside manners left alot to be desired. The reality is we do not have as much information about ArtGirls situation as her trusted endo does. We can provide advice and share experiences but it has to stop there.

    and for the record we in this household try to stay between 80 and 180 as well. Sure we will correct down a 180 if we see one but someone saying they have been as high as a 180, well for a T1D of *any* stripe thats not bad.

    Here is an example, just a few days ago we went a few hours past the 48 hours our pump sites seem to last (first world problems) and DS soared into the 300's. So here I am presumably using state of the art insulins, technology, and now with 24 months of experience, and I saw a 350. So pouncing on a newly diagnosed family over a 180, I mean really? For 3 weeks after we left the hospital our average was 200 as they gradually adjusted his ratios.

    Finally, while its not often we see people talking about NPH that doesnt mean people cannot be successful on that regimen. I have no experience with NPH. On that aspect of her daughter's care I will remain silent. Different does not mean better or worse, it just is different. I looked up NPH in Think Like a Pancreas and lo and behold there was *tons* of information in there about it. There is almost always more than 1 way with T1D.

    So hopefully ArtGirl returns and in a year she will be our resident expert on NPH!
     
    Last edited: Nov 22, 2015
  8. wilf

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    As said, I'm simply disappointed - and astounded that you would think that your sort of post constitutes "advice". I sure hope you don't treat your patients the way I'm seeing you treat someone who's come here for information and help.

    Your posts are absolutely unhelpful, and I'd suggest that if you can't find a more constructive way of expressing yourself then you'd do well to refrain from posting.

    About the only thing we agree on is that it would be good for Artgirl to be measuring blood sugars overnight.
     
  9. forHisglory

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    There is info out there about children that experience hypoglycemia in regular bouts and sometimes it can mean they will go on to develop diabetes. I have a friend with a child right now that has had 1 seizure like episode (passed out, twitching) during PE class at the YMCA, medics called and he had hypoglycemia, and several minor episodes since that were purely hypoglycemia related. He hasn't seen an endo yet because his bloodwork is always normal at the ped and the parents don't have great insurance but they talked about diabetes as a possibility. I'll see if I can find that info again for those that haven't heard of the coorelation.

    Also, if 80-180 range is unacceptable than we are failing too (NOT). We have meal spikes that go to 250 very often and then a few 300s. Our A1C is still decent and under 7.5.

    Update: looks like hypoglycemia is often related to type 2 diabetes diagnosis. I haven't located a research article but found that "prediabetes" can be a cause....
     
    Last edited: Nov 22, 2015
  10. StacyMM

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    I thnk that's fairly common advice and from what I see online, 100 is a comfortable number for a lot of parents, which is pretty close to your 6. I would also caution you to keep insulin on board in mind. If she has a snack and a shot an hour before bed, there would still be active insulin working. When we first joined the diabetes world, we were completely unaware of how it worked and what it meant and had no idea that it would take so much management. I admit that I thought it was a "take 3 shots a day and you're fine" kind of thing. I was so, so wrong, and in the beginning we just did everything the endo suggested. For me, my daughter was young and DH or I could test her BG before we went to bed and her number was more than 4 hours after she had eaten. I think her original target range was something like 100-200 and it was a good starting point for us. Eventually, and the endo will help with this, many parents take over the decision making, but in the beginning the endo was a great resource. When you are ready, or if you are just worried and want more info (knowledge helps with the fear because the unknown becomes known), there are some great books that will help explain T1D to you.

    Over the years, we have done no middle of the checks, lots of middle of the night checks, some middle of the night checks. Different situations, different regimens, different ages, etc. My kids wear CGMs now so it's a matter of getting up for alarms. I do love Dexcom and regret that it took us so long to try it. I do wish the endo had pushed us toward one...it was online groups (like this one) that made me realize what we were missing. For us, it's been a great tool...but many, many parents/kids manage without one. It's a decision you'll need to figure out for yourself.

    As to waking for lows...again, it's something that you will learn for yourself. It really depends on the person. My daughter has never, in nine years, ever woken up with a low. Ever. My son, however, has woken to lows several times. In fact, a few nights ago he came in and woke us up. He was in a two hour restart and had dropped really fast. We wouldn't have gotten up to calibrate for another half hour or so. While I wouldn't depend on him for waking up, I would say that he has regularly done so. For where we are now, we woudl be doing multiple checks during the night if not for the CGM. Puberty, sports, new MDI routine...it's just something I would need to be comfortable. But that's us and our situation. Older child, honeymooning, numbers between 80-180, it's a completely different situation.

    Welcome to the group. Sorry you had to join - diabetes sucks.
     
  11. Artgirl

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    Thanks for the replies and words of encouragement....I think her honeymoon is over soon because when I look back I am pretty sure she's had this for a while, I would say close to one year. I am thinking we have to make adjustments to her insulin here and there before we get to a normal range, which they said is all normal in the first little while, I have a number to call fro adjustments. I am also sure that once we are used to all of this the more modern meds and treatments will come available to us, remember we are less than 2 weeks diagnosed. I am still confident in out hospital and team that is dealing with us, and yes I have access to a social worker as well. It will be a journey for sure not one I want to take but I love the fact that my daughter is telling me she feels way better with the insulin and that she now has learned to inject herself is amazing....I am so proud of her...when she goes off to University I hope she is ready to cope. I know she will.
     
  12. Sarah Maddie's Mom

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    Again, I really encourage you to do some reading about the basics of diabetes. She is most likely only just now entering her honeymoon. Many kids are on relatively high doses at dx, within a few weeks as the body begins to recover and the remaining functioning islet cells get some respite from the introduction of injected insulin, and doses plummet. Your endo should have made you aware of this and to be ready to reduce the dose when you see persistent lows.
     
  13. wilf

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    Agreed, in terms of the honeymoon possibly being yet to come.

    Artgirl, if you suddenly are seeing lots of lows then that may be what is happening.

    And without a reference text you are sunk. You need to educate yourself. Type 1 Diabetes by Ragnar Hanas is the best reference book I know of regarding Type 1 Diabetes. :cwds:
     
  14. Nancy in VA

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    I think this should be the motto of our board!
     
  15. Nancy in VA

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    My child has been diagnosed almost 9 years. And there are very FEW days that she will stay all day between 80 and 180. We celebrate if she does. She experienced a lot of 300s and a lot of 60s right from the start and has ever since. I'm convince some people's bodies are just affected differently than others.

    And, just so other know, my daughter goes to Children's Hospital in Washington, DC. They start EVERYONE on NPH/Regular. Mainly because they don't know, out of the box, what kind of family/home situation the patients are in and sometimes, guaranteeing 2-3 shots a day is a struggle. They treat people all the way from indigent homeless to multi-millionaires and they all start on NPH. The only reason we didn't is that we were diagnosed at a different hospital and started on Lantus and Regular - kinda a weird combo - so when we shifted to Children's 3 weeks later she threw a vial of Humalog at us and gave us a formula and said "have at it". P
     
  16. Nancy in VA

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    Honeymoon has less to do with how long they have been developing it and more to do with how much "bang" the pancreas has left. After suffering with depleted insulin production, shots of artificial insulin finally give the pancreas a break and it can regulate itself again for a while, so you'll see more normal numbers with less insulin. But really its just the last hurrah of the pancreas.

    We can look back about 3 months and see Emma developing diabetes, but we basically had zero honeymoon. ZERO. I see people here who end up with basically no basal/Lantus and very little insulin at meals during honeymoon and they stay in the 80-180 range. That never happened with us. We were always seeing 300s - never stopped - still haven't.
     
  17. Just Jen

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    I second that!!
     
  18. Snowflake

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    Same here. I've made this point in other discussions of honeymoon on these forums: Not all kids honeymoon. I wish someone had told me that as a newbie, because I kept anticipating it and it never happened. Instead, my daughter ran unnecessarily high in the weeks after diagnosis because the drs and the books told us to expect help from her pancreas that never arrived.
     

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