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Thread: Honeymoon has definitely ended :(

  1. #1

    Default Honeymoon has definitely ended :(

    Hi all,

    well my daughters honeymoon phase has ended, and boy you were all correct about enjoying it. Her phase lasted roughly one year then her numbers have been increasing with the same amount of insulin. She sugars spike almost daily and there is absolutely no sneaking in a snack without sugar highs. Actually her sugars are getting almost impossible to keep in range lately. We are reviewing her insulin requirements again and taking daily logs to find out what will hopefully be her final insulin ratio. Her Lantus is 22 units which seems to do nothing for helping stabilize her numbers.For those of you on Lantus, how much do you take. I feel like we are learning this all over again. Just needed to vent, hope you all have a great day. PS. I hate this disease so much.
    Carla mom to a lovely 17 year old daughter with Type 1 diabetes diagnosed Nov 15/2015
    Nov15/2015 to March/2016 NPH therapy Humolg/Humilin N
    March2016 ongoing MDI therapy Lantus/Humalog
    17 year old son (twins with my daughter)
    15 year old daughter with Down Syndrome/Legg Perthes disease

  2. #2

    Default

    What others take is really irrelevant. Follow the directions in Think Like a Pancreas to get to stable (ha!) nights, and then adjust the correction factors, carb factors, etc.
    8/2010 - 9/2011 MDI, Lantus & Humalog
    9/2011- Medtronic Revel 723 & CGM
    11/2012 - Dexcom G4
    2013 - Cut-The-Cord for water times after multiple Aquapac failures
    10/2015 - T-slim

    "Life is not waiting for the storms to pass, but learning to DANCE in the rain."

  3. #3

    Default

    Unfortunately there is no such thing as a final insulin ratio - both my kids have been at this for 10+ years and although things seem relatively stable, their ratios are always being adjusted. You probably need to visit your team to get new strategies on how to handle things now that the honeymoon is over.
    On another note, if you don't do so already, make sure you take note of blood sugars vs where your daughter is in her monthly cycle. My daughter had different ratios depending on the time of month and they are quite different.
    Pay attention to what types of foods she eats - not just carbs. Not all carbs are equal. For instance, my son has different ratios depending on if he is eating say potatoes vs pasta vs rice. Lastly, make sure she is accounting for every bite. What made our life easier when trying to figure things out was to have the same meals for 2 or 3 days straight - it gave us a "control" from which to fine tune their dosages.Of course, when you have been at this as long as we have, you also have to remember that no matter how well you control things, diabetes doesn't always cooperate. Our excuse for wonky days is that the stars and planets are out of alignment in some far off galaxy...
    It gets better - you are still pretty new to this and important to know that "good enough" is often "great" when you are talking about diabetes - the stress of trying to be perfect is worse for everyone than some wonky numbers. Good luck!

  4. #4
    Join Date
    May 2009
    Location
    Georgetown, TX
    Posts
    2,205

    Default

    Quote Originally Posted by Artgirl View Post
    We are reviewing her insulin requirements again and taking daily logs to find out what will hopefully be her final insulin ratio.
    It sounds like maybe you don't know how to make those adjustments yourself? Relying on a doctor to manage all changes is a guarantee for poor control long-term. Being in the honeymoon period has possibly sheltered you form the reality of that... but knowing how and when to make your own insulin adjustments is honestly key to successful diabetes management long-term. At 17 this is something that your daughter should be actively involved in learning to do as well.

    Think like a pancreas is a great place to start
    Sarah T1 @ 20 (10/2000), Hashi's @ 24 (10/2004)
    mom to 3 non-D kids (9, 11, & 16)
    currently running Loop with Humalog and Dexcom G5 since 7/2016 because #WeAreNotWaiting

  5. #5
    Join Date
    Aug 2007
    Location
    Hamilton, Canada
    Posts
    9,623

    Default

    Quote Originally Posted by Artgirl View Post
    Hi all,

    well my daughters honeymoon phase has ended, and boy you were all correct about enjoying it. Her phase lasted roughly one year then her numbers have been increasing with the same amount of insulin. She sugars spike almost daily and there is absolutely no sneaking in a snack without sugar highs. Actually her sugars are getting almost impossible to keep in range lately. We are reviewing her insulin requirements again and taking daily logs to find out what will hopefully be her final insulin ratio. Her Lantus is 22 units which seems to do nothing for helping stabilize her numbers.For those of you on Lantus, how much do you take. I feel like we are learning this all over again. Just needed to vent, hope you all have a great day. PS. I hate this disease so much.
    Setting Lantus is a cinch. You give here as much as is needed to keep her blood sugars steady or very gently drifting lower overnight. You let yourself be guided by overnight numbers, which does mean you have to do some measuring at night especially when you're first getting the Lantus set right.

    So let's say that right now she typically rises 30-50 points overnight. That is not good - it's a recipe poor control around the clock. You would start upping her Lantus by a unit a day (keeping close watch with overnight tests) until there is no more overnight rise. Once the Lantus is set you then turn your attention to the carb ratio and correction factor - but there's no sense worrying about these till the Lantus is at a good level.

    Please note that there will never be a "final insulin ratio". Your daughter's insulin regimen will evolve throughout the rest of her life, depending on lifestyle, physical activity, diet and a variety of other factors. If anyone is telling you that they can help you find her "final insulin ratio" then run the other way 'cause it just doesn't work like that.
    ________________________________________
    Wilf

    Proud Dad of Amy (19), diagnosed Aug. 2006 and getting MDI of Apidra, Regular and Lantus..
    and Sylvie (15); very happy husband of Shirla!

  6. #6

    Default changing settings

    Hi Artgirl,
    Just wanted to say we review our son's basal, IC and ISF settings at least twice a week (more if he's had a string of bad hypos or consecutive highs at the same time each day), and usually make one or two tweaks at those times. I track all the changes in a basic spreadsheet document.

    What I've found from looking over the data is that if we go more than two weeks and haven't made any changes, his control worsens. Keeping on top of trends and constantly tweaking settings can be exhausting, but it really does work better for us. And the workload feels less overwhelming if we set it as part of a routine. For us, the routine is for me to look through settings during my son's bath time, but for an older girl you'll likely have some other "quiet" time of the day.

    Good luck, I know you're entering uncharted territory. Know that it does get easier. Not that your daughter's blood sugars will necessarily be more predictable -- but somehow with effort and experience you'll just get better at predicting the unpredictable. Of course, diabetes is awful and it will always throw you those curveballs, but they'll feel much more manageable with time.

    Hang in there!
    1 2-year-old T1D boy
    pumping Minimed 523 8/16
    Dexcom G5 5/16

  7. #7

    Default

    I would HIGHLY recommend that you and your daughter go through the Type 1 University classes together. http://type1university.com/ Your daughter is at an age where she'll be launching soon but still needs support. The classes are excellent and should get her going on the right path of management. After you've taken the classes, I'd highly recommend getting a contract for her to work with Jenny Smith for a year as she transitions to college. Jenny gets it in ways their endos, us, etc. don't. Jenny's lived with T1D since she was 13, so she's been through the stages our kids are going through and can relate to them, while also mentoring them in diabetes management. Jenny works for Gary Scheiner (author of Think Like A Pancreas) at Integrated Diabetes. http://http://integrateddiabetes.com/
    Last edited by MomofSweetOne; 02-25-2017 at 10:40 PM.
    8/2010 - 9/2011 MDI, Lantus & Humalog
    9/2011- Medtronic Revel 723 & CGM
    11/2012 - Dexcom G4
    2013 - Cut-The-Cord for water times after multiple Aquapac failures
    10/2015 - T-slim

    "Life is not waiting for the storms to pass, but learning to DANCE in the rain."

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