advertisement

Page 1 of 2 12 LastLast
Results 1 to 10 of 12

Thread: Honeymoon Microdosing Finding the Sweet Spot

  1. #1
    Join Date
    Mar 2017
    Location
    Wisconsin
    Posts
    10

    Unhappy Honeymoon Microdosing Finding the Sweet Spot

    Our son is 7 and was diagnosed a month ago. He's apparently in the honeymoon stage.

    We keep needing to drop the lantus dose and are down to .5 units before bed but still see a drop in bg of about 150 over night. To combat this, we're giving him about 60g carbs for snack before bed (his usual meals are only about 30g).

    His bolus is .25u to about 30g carb and he usually has a small snack between meals.


    We've been in constant contact with the endo clinic but have started doing some adjustments on our own.

    One thing I'm considering is dropping it once again to .25u. Since he's on Spring break it's the perfect time to try it. I'm also wondering about dosing the lantus in the AM so it's not so effective overnight. Does anyone do this with their kiddo?

    I don't expect to find a perfect sweatspot, I know his needs will continue to change, but it would be nice to find a dose that will get rid of the bedtime carb cramming and middle of the night "snacks"... which he HATES.

    Last night I slept through his 2 am check and I feel terrible. I don't even understand how I could have. That's a scary thing... anything can happen at night. Thank God he was 112 this am.

  2. #2

    Default

    Hi

    Have you considered getting a pump? I know it's a tad early, but that's what helped us solve the 'night issues' during honeymoon for our son. We kept on reducing the lantus, changing the timing of administration but he was still going low at night. With the pump, slow acting insulin is replaced by a basal rate of Novolog / fast acting that you can modulate as much as you want (you can drop it to 0 in the middle of the night). Generally we found that we've had to modulate the basal quite a bit during the day to achieve better control, with rates as high as .7u/hour or as low as .05u. Just a thought, I know how overwhelming these first few months are...

  3. #3
    Join Date
    Mar 2017
    Location
    Wisconsin
    Posts
    10

    Default

    We changed the lantus to AM yesterday and last night was a little more smooth, no major drops but it's still a gradual one. That's probably to be expected?

    I'm definitely already thinking about a cgm/pump but my understanding is that our insurance doesn't cover it for children under the age of 16. However, it can be overridden for special circumstances and with prior authorization. I'll certainly be talking to his dr at his appointment in 3 months.

  4. #4
    Join Date
    May 2009
    Location
    Southern CA
    Posts
    692

    Default

    Quote Originally Posted by MMMMMMM View Post
    We changed the lantus to AM yesterday and last night was a little more smooth, no major drops but it's still a gradual one. That's probably to be expected?

    I'm definitely already thinking about a cgm/pump but my understanding is that our insurance doesn't cover it for children under the age of 16. However, it can be overridden for special circumstances and with prior authorization. I'll certainly be talking to his dr at his appointment in 3 months.
    When we were on shots, AM lantus was very helpful in avoiding the nighttime lows. If you & your child are interested in the pump, ask at your visit. The folks who advocate for our kids to get pumps are skilled at what they do & they can help get the approval from your insurance.

    Good luck in the diabetes journey!
    Kim
    Mom to Danielle, age 18, dx'd type 1 age 3 in 2001. MM 630G pump with cgm. dx'd celiac 6/09
    She will be a sophomore at University of Utah in the fall 2017.
    Go Utes!

  5. #5
    Join Date
    Mar 2017
    Location
    Wisconsin
    Posts
    10

    Default

    thank you.

  6. #6
    Join Date
    Mar 2017
    Location
    Wisconsin
    Posts
    10

    Default Now Getting Lows all Day after switching to morning Lantus.

    Since we switched to AMs he's now getting lows all day. Most just between 60 and 80 but yesterday he had 2 in the low 40s. Nights are doing much better which is nice not to worry as much about but I got 3 calls from school today about his lows! The on call doctor says there's nothing more we can do other than increase his mealtime carbs intake and he is such a picky eater it's hard to get him over 30 carbs unless it's unhealthy stuff. He would gladly eat junk all day long.

  7. #7

    Default

    Ah, that's pretty tough. The pump really would be ideal for you in this situation. In this day and age, I would be shocked if your insurance denied the claim, especially since your doctor will be able to write a letter of medical necessity. In the meantime, well, some "junk" is better than him having to fight lows all day at school.

    Best of luck to you!
    Mom to J., age 13
    Dx 2007 @ age 3
    Medtronic pump and CGM (4/2008-6/2013)
    Tandem t:slim and Dexcom G5 CGM (current)

  8. #8
    Join Date
    Aug 2007
    Location
    Hamilton, Canada
    Posts
    9,623

    Default

    Quote Originally Posted by MMMMMMM View Post
    Our son is 7 and was diagnosed a month ago. He's apparently in the honeymoon stage.

    We keep needing to drop the lantus dose and are down to .5 units before bed but still see a drop in bg of about 150 over night. To combat this, we're giving him about 60g carbs for snack before bed (his usual meals are only about 30g).

    His bolus is .25u to about 30g carb and he usually has a small snack between meals.


    We've been in constant contact with the endo clinic but have started doing some adjustments on our own.

    One thing I'm considering is dropping it once again to .25u. Since he's on Spring break it's the perfect time to try it. I'm also wondering about dosing the lantus in the AM so it's not so effective overnight. Does anyone do this with their kiddo?

    I don't expect to find a perfect sweatspot, I know his needs will continue to change, but it would be nice to find a dose that will get rid of the bedtime carb cramming and middle of the night "snacks"... which he HATES.

    Last night I slept through his 2 am check and I feel terrible. I don't even understand how I could have. That's a scary thing... anything can happen at night. Thank God he was 112 this am.
    I missed this when you first posted.

    The switch to Lantus was a good decision. Giving Lantus in the morning is a great way to deal with dropping numbers overnight.

    While he is in the honeymoon, his body will naturally pull his blood sugars down to the 60-80 range. Don't make the mistake of fighting that with carbs, as he is producing enough insulin that he'll drop nonetheless. Just go with it and give some overnight checks to make sure he's not going below 60. His body will tend to pull him down to the zone it is comfortable with (as said, usually 60-80) but then will stop and he'll generally hold steady with great waking numbers.
    ________________________________________
    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!

  9. #9

    Default

    Several things:

    1) Learn to be your son's best advocate. Just because the policy on a pump might be "6 months" or whatever doesn't mean you can't fight it and win. From what you described, the microdosing a pump can do (.025 unit) would make a huge difference in your son's management. He'll feel better, have lower risks, and more.

    2) Switching Lantus to morning was a good move. We actually did the opposite as my daughter climbed during the night, but the endo initially recommended morning dosing until we learned what was happening.

    3) When my daughter had to eat all day to be stable at night, we switched to the pump. It was revolutionary. She didn't feel well on MDI. For us, it was puberty hitting full blast overnight.

    4) Most kids do become quite good at juice guzzling in their sleep.

    5) Sleeping through alarms is scary, even several years in.
    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."

  10. #10
    Join Date
    Mar 2017
    Location
    Wisconsin
    Posts
    10

    Default

    Quote Originally Posted by MomofSweetOne View Post
    "Life is not waiting for the storms to pass, but learning to DANCE in the rain."
    I love this quote. I've had it in a frame on my work space for years. I don't feel like dancing in the rain right now and it's nearly impossible to believe the storm will pass.

    I'm wondering what MDI is, I'm still learning a lot of the terms.

    His next appt. was in three moths but I was able to move it up to the end of the month and discuss a pump/ cgm. My understanding is that dexcom isn't the same as a pump?

Tags for this Thread

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
advertisement