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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. Becky Stevens mom

    Becky Stevens mom Approved members

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    Hi Denise, I had questioned whether you tested again but saw that you did. I was wondering what Jake had for supper that night. Was it something real fatty? Pizza maybe or French fries will cause a spike in Steven. Or does he have a snack at night like ice cream? We have to be careful when we correct those highs as the fat will finally digest and then Steven will drop if we give a whole correction. Our endo and CDE did tell us to do 50% corrections at night to avoid the sudden drops after fat spikes and for Steven that usually works
     
    Last edited: Mar 13, 2012
  2. Jake'sMama

    Jake'sMama Approved members

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    Sarah, this post seemed a bit critical of us, that we should know more at 3.5 years. Perhaps it was the brevity.

    Endo stands by his correction factor.
     
  3. Jake'sMama

    Jake'sMama Approved members

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    Thanks all - I appreciate your information more than you can know.

    At clinic today Endo said Novolog peaks 1-1.5 hours. So DH just needed to be a bit more patient. We're getting the hang of this... slowly.
     
  4. Lee

    Lee Approved members

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    But that makes no sense with the Logs - I get variable sensitivity factors between night and day - but honestly, a 50% cut in sensitivity makes no physical sense, unless you are correcting for an adrenaline high...

    I, for one, do not see how Sarah was being critical of YOU - she was being critical of YOUR ENDO - which for the record, so am I.

    A 1/2 a unit - yes - but 50%? Unless the correction is 1 unit, I can't even wrap my brain around it.
     
  5. hawkeyegirl

    hawkeyegirl Approved members

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    Well, and in this situation, 50% wasn't even right, as he went low. There is no one size fits all correction factor. The reason for the high plays as big or a bigger role in the correction factor that you use as time of day does. Your endo isn't going to be much help figuring that out. That's learning you have to do on your own.
     
  6. hawkeyegirl

    hawkeyegirl Approved members

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    Well, I do think at 3.5 years in you should know when the insulin that you're using peaks, yes. I'd highly recommend getting the following books:

    Think Like a Pancreas, by Gary Scheiner

    Type 1 Diabetes, by Ragnar Hanas

    Using Insulin, by John Walsh

    Personally, I'd start with Think Like a Pancreas. It's the shortest and most accessible, and full of information that you need to become more independent in your dosing decisions.
     
  7. sooz

    sooz Approved members

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    But it is a guessing game isn't it? We can all be as informed as possible, do everything exactly right, and STILL be surprised at the next number we see on the meter. That is what is so frustrating and crazy making and why it is so easy to get confused sometimes. It all changes at the drop of a hat or a little extra physical activity during the day that you might not know about, or a growth spurt, or hormones, or fighting an illness, or because it is Tuesday. It can be an informed guessing game, but it is still a guessing game.
     
  8. hawkeyegirl

    hawkeyegirl Approved members

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    The more knowledge you have, the less you need to guess. Of course we all have to use our best judgment and sometimes we are wrong, but DIA is basic D knowledge that is necessary to even have a fighting chance of being right.
     
  9. Mish

    Mish Approved members

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    I have to disagree partially. Informed guessing sometimes happens but informed is the key word: I dosed 50/50 for pasta last week and it didn't work, lets try 60/40 today. And then you try something different next time. But that's with the eventual knowledge that you'll come close to getting it right. And it's also based on the knowledge of knowing how insulin and food work together, in my child, on any given day. But guessing shouldn't be the norm. Nor should we just say "eh, it's diabetes, it is a guessing game."

    Why shouldn't an endo be stepping in after 3 years - with 3 years worth of data - to help this family a little bit more to pin things down? It is clear from the first post and subsequent posts that the issue really was two fold: how long does insulin last and how much should the correction be at this specific situation, based on all previous experiences. I can't really say it better than Sarah said a few posts back:
    because it wasn't only that it was a guess, it was the wrong guess, and one which the endo continues to support. And that goes back to my earlier post: Where does that get the OP? Absolutely nowhere. The endo has helped her learn nothing and the next time her son is high she'll still be instructed to do a 50% correction which seems to be just a number arbitrarily pulled from the endo's butt.

    Like Wilf and others have said, we also sometimes do 50% corrections at night, but I think for everyone who posted it's that
    1) a 50% (or whatever number )correction is the right correction for night for that child

    or

    2) that there is some other factor at play on during that particular high which makes a 50% correction "guess" the appropriate thing to try.

    In this case, none of those were true. 50% was too much and the endo's advice that novolog peaks at 1 1/2 hours doesn't really help because the child still went low long after the correction should have been done with.

    Again, the criticism (if there really is any) is with the endo. Luckily this parent has knowledgeable fellow D parents here(all with different tricks and techniques and styles) who are more than willing to assist her to fill in the gaps where the endo seems to have fallen a bit short.

    And in the end, if the OP is happy with the endo that's perfectly ok too.

    But back to your original question/statement: Why should anyone have to guess when we all have a lot of tools at our disposal which to take some of the guesswork out of what is a tiring and often erratic disease? Doesn't it help us all have just a tiny fraction of sanity when most of the time we have none?
     
  10. Jeff

    Jeff Founder, CWD

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    Removing nonsense, closing thread.

    People, really, you have nothing better to do than this?

    Sorry to the OP.
     
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