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398 BG at bedtime - correction ?

Discussion in 'Parents of Children with Type 1' started by Jake'sMama, Mar 12, 2012.

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  1. Jake'sMama

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    we did a 50% correction as per Endo. 45 minutes later he is still 377. Do we correct again? Wait longer?
     
  2. wilf

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    What is a 50% correction?
     
  3. wilf

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    I'm not sure if you've learned about how long insulin is active in the body yet, but after 45 minutes maybe 10-20% of the insulin has taken effect - you have 80-90% to come. I'd wait until at least the 2.5 hour mark before correcting again..
     
  4. Jaredsmom

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    Wait for your insulin to peak at 2 hrs before giving any more. Why the 50% correction is it because it is bedtime. We usually went with more like a 75% correction at bedtime when we were on MDI. Now we just set his pump to correct him to 120 at night.
     
  5. Jake'sMama

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    50% of what we'd give during the day.

    so I'd normally give him 3 units, so at bed I gave him 1.5 units.

    Usually he comes down within an hour, maybe not to in range but more than a couple of points.

    thx
     
  6. Jaredsmom

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    Sorry didn't realize or look to see that you are on novalog. It takes longer to peak more like 2.5 to 3 hrs so I wouldn't give anymore until that peaks like the other poster said very little of you insulin has started to work at this point so you wouldn't want to give anymore. Sorry we are using apidra which peaks alot sooner.
     
  7. virgo39

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    You may have hoped for a greater decrease in that time, but 45 minutes is not a great deal of time adn as BG goes up, the margin for error on the meter might also be greater.
     
  8. TheFormerLantusFiend

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    I would give it two hours, and at that point if it was below 300, leave it alone; otherwise correct again (if below 200, a snack might be necessary). I tend to assume that after two hours, about half of the insulin's action is done.
     
  9. Jake'sMama

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    i appreciate the info!
     
  10. Sarah Maddie's Mom

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    I think if you are 3.5 years in and still doing 1/2 corrections then your correction factor is way off and should be adjusted. JMHO.

    Hope it works out tonight.:cwds:
     
  11. wilf

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    Why? :confused:

    We do half-corrections at night. If we give the same corrections in the evening that we do during the day, then DD goes low. Every time.

    We've learned through numerous observations that evening corrections need to be 1/2 strength to keep our daughter safe. Less insulin goes further in the evening and overnight for her, and apparently for the OP's child as well..
     
  12. Sarah Maddie's Mom

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    I think that after so long doing a night correction should be a more confident exercise. I'm not blaming the OP, I'm just saying that having to give 1/2 a correction can be - and obviously is, in this case - more stressful that just knowing that at night a different correction factor is in play.

    I know exactly what you mean - I do tons of % corrections but the OP seemed unusually unsure about the effect - given that, it seemed to me that they should have a less stressful ratio. ;)

    added... sometimes I do 50% sometimes at night I'll do 150%, depends on why she's high and what other factors are at play, but I know pretty much what works for my kid, if I were unsure I'd want the endo to help me come up with a better correction ratio for nights.
     
  13. wilf

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    I agree that it seems that some more learning about how (and how long) insulins work is indicated.. :cwds:
     
  14. dzirbel

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    We were on 50% corrections before the pump also. Her correction factor was 60 during the day and 120 at night. That was in Georgia. After moving to Cincinnati and going on the pump they changed it to 90 all the time. We've since had to adjust it to 100.

    I think every endo has their own idea of how it should work. Our range in GA was 70-150, correcting down to 100. Here her range is 70-120, correcting down to 120. A good endo should be teaching the parent how to make these adjustments. Not just telling them how, but brainstorming with them on what would be a likely cause of a high or low and how to treat it.

    I will say that I am much more confident in making changes on the pump then with MDI. On MDI I did have to make some "gut instinct" decisions on how much correction to give based on the days activities and food.
     
  15. Jake'sMama

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    Honestly we have done very few corrections at bedtime in those 3.5 yrs, which is why I posted.

    As it was, he went low overnight and we had to wake him for a snack. A full correction would've surely required glucogon, which we've never used either. (and yes we retested to verify the results)

    Sarah Maddies' Mom - there are no stupid questions, right?

    Wilf, I appreciate your willingness to answer and educate. You are a gem.
     
  16. Sarah Maddie's Mom

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    ? Not sure I understand that...
     
  17. Mish

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    so what does that say - that you need a better system of night time corrections with a more accurate number than a guess at 50%. Right? 50% didn't get you where you wanted to be.

    I think that's what Sarah Maddie's MOm was getting at. That after 3 years your endo should be helping you pin it down a little bit better, because diabetes shouldn't have to be a guessing game. (and I think she went out of her way to say this was no fault of yours.) I don't see that you've really learned anything in this thread other than 50% correction at night doesn't work. And that you need a better system. Thank you Sarah for that.
     
  18. Lee

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    Well said - and gee - it is exactly what Sarah said. :cwds:

    Also, 45 minutes is just not long enough to wait to see the blood sugar come down...

    We have always had two correction factors - even back on MDI. Your endo should give you a different correction factor for night - end of story.
     
  19. mmgirls

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    lets help a bit more here.

    At what BG number would you think about giving a correction at night?

    what is his correction factor? and what number do you correct to at night.

    Also for comparison how does that compare to during the day time?

    I beleive that we will find that either your son is very sensative to insulin or that you do not correct until a faily high bg at night. Or both and that can be problematic in itself, because of the sensativity.
     
  20. hawkeyegirl

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    It wasn't a stupid question, and if you re-read Sarah's answer, she turned out to be exactly right.

    Do you know why he was so high? I correct differently depending on the reason for the high. One correction factor (or even two) do not fit all situations.
     
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