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What would you do?

Discussion in 'Parents of Children with Type 1' started by bbirdnuts@aol.com, Feb 5, 2010.

  1. bbirdnuts@aol.com

    bbirdnuts@aol.com Approved members

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    Would you treat a 96 at 3am? This is what I did. Carolina's blood sugars have been going low within 1 hour after eating (she does a 10 min. pre bolus). I have been treating a low after every meal except breakfast. I decreased the amount of basal she is getting during the day and the nights have been semi ok. Only highs have been from overtreating. Last night at 11pm her blood sugar was 211. Earlier I had treated a low and in the meantime she wanted a snack and her Pod had to be changed. Only bolused her for what she was eating. Two hours later she was 211 it was 11pm and I gave her 1.05u of a correction (using a 60 correction factor). I used a 20 carb ratio with her snack and I believe that was too high a ratio. I checked her at 1am and her blood sugar was 131 (wanted to check the correction). I set a clock to check again at 3am and her blood sugar was 96. This is what I did -- what would you do? I gave her 2 oz. of juice at 7 carbs and checked her 20 mins. later and she was 101. I changed her basal from 12am - 7am to .45 it was set at .50. What would you do now? Would you stay up and check again? Go to sleep set an alarm and retest? Go to sleep and wait until morning?
     
  2. StillMamamia

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    I can only speak for us, but a 96 at 3am for us is not much of a concern for now. But since you may have basal issues (or maybe delayed activity insulin sensitivity kicking in) then yes, I would have treated it and rechecked in 1hr.

    As for going low 1 hr after eating, I would forgo the prebolusing for now. Maybe it's due to the low-GI, slow-digesting stuff she eats:confused: Or basals may just be too high as well.
     
  3. colebenmom

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    I would treat but Ben is still honeymooning. He dropped over 100 points last night without any IOB. I would have stayed up a little longer to wait and see if he came up anymore. Good luck. I hope you got some sleep and you get some resolve with her lows.
     
  4. Gracie'sMom

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    We use a CGM, so for us it would depend on the arrows. If she was trending down, we would treat it. If she was stable or trending up we would let it be. Without a CGM, I would probably treat but not aggressively, maybe 1/4-1/2 of a juice correction. Our endo likes her to be above 120 during the night if possible.
     
  5. Amy C.

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    96 is in range for my son. I would be pleased with that reading.
     
  6. RosemaryCinNJ

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    For Amanda at 3 am I would treat it as a low...or headed towards one...and would make her drink a juice box..only because one of her basals is set at 3 am and she does get insulin through her pump..so yeah I would treat it just to be on the safe side here...

    *Her pump is set so anything below 100 is considered a low, even though it is not.., Endo does not want her going below 100 especially in the middle of night.
     
  7. Logansmom

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    We treat under 100 at our 230a test. What we typically do is give 1/4 of a graham cracker which raises his BG 30 points. We do this as our testing has shown that if we don't, he will wake up in the 60's.
     
  8. mom2two

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    Before the CGM I would have treated with 4 grams, now I do a BG check and go by the arrows on the CGM. If it says stable(arrow going across) I leave him.
     
  9. kiwikid

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    96 at 3am is perfect for us. I'd roll over and sleep soundly at anything over 4.5 (80).
    We have done a few overnight basal tests though and I know that Rachel is usually steady as a rock at that sort of number for the rest of the night :)
     
  10. sooz

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    If you are worried you could also suspend the basal until morning I think.
     
  11. Toni

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    Wonder how this turned out for you. I would cover all insulin on board (10 grams of carbs for every unit on board) if she was 96. I usually bump her up to about 110 to 120 sometimes 130 depending on how she has been trending over the past day and the night before. Of course this can backfire.... without cgms on it is a guess. Usually it works out. Not always.
     
  12. Flutterby

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    It'll would all depend on what the trend is on her cgms..if its down hill, yes, I'd treat it.. straight line and I was staying up a bit, no I wouldn't.. straight line and I wanted to go to bed.. I MAY treat it, but it would all depend on what else was going on that day. ;)
     
  13. saxmaniac

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    What?? Careful with this. 4 hours with no basal or IOB is a long time and dangerous. If I did this I'd be looking at a 400 and large ketones.

    For things like a 90 I might reduce the basal by 10% for an hour or two at the most.
     
  14. Nancy in VA

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    Since it was almost 4 hours since the correction, I would think she's probably ok. I still wouldn't treat a low until under 80, even at night.

    But, I would not change the basal because of readings during a correction. The only way you know if the basal is right or not is to see it at a time where there are no correction. You'll see a lot of people talk about basal testing.

    If she's going low 1 hour after eating, her I:C is too high - bring it down
     
  15. sooz

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    You are right, although for us 96 is not considered low, so I wasnt clear where she wanted to be. I would not turn off the basal, but if she were really worried you CAN turn it off for short periods. I didn realize it was a four hour time frame. Reducing it is much better. Guess I should be more careful with my reading in the future..very sorry! :(
     
  16. bbirdnuts@aol.com

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    Ok, here is the rest of what happened. I checked her at 5am, bs 121, 6:35 104, basal .55 starting at 7am, 8:39am 97. I changed the basal to .50 because she is still sleeping. She wakes up to eat at 9:40 I bolus her and her bs is 106. Then at 10:28 (not one hour from breakfast bolus) she is 87 and knows she is still dropping. Dropped the basal to .40 at 1pm. Gave her juice and brought her up to 145 at 2pm so I could sleep and at 4:30pm she was 85. Many times after a meal if within a one hour range from the bolus she may say I'm going low and she checks her blood sugar she is usually in the 80's. I have made her wait on several occasions and within 10 - 15 mins. she's in the 50's. When she feels she is going low and it is soon after a bolus I will gently correct her in the 80's.

    Sorry I have not posted earlier, but we are down to one computer. Carolina seems to always be online doing school work.:rolleyes: and my computer time in extremely limited.
     
    Last edited: Feb 6, 2010
  17. Nancy in VA

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    What do you mean by "you dropped the bolus"? Are you adjusting the basal or the I:C ratios?

    It still sounds like your ratios are high? If you are dosing, for example, 1:10, I would maybe change it to 1:12 or 1:14.
     
  18. bbirdnuts@aol.com

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    Sorry I had a typo. It should have read basal and I typed bolus. She was still sleeping so I was changing the basal because of the frequent lows. The I:C ratios and correction factors have also been increased.
     
  19. wilf

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    Those look like pretty good numbers to me - way to go Mom! :)
     

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