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87, 111, 95

Discussion in 'Parents of Children with Type 1' started by Teacups, May 6, 2011.

  1. Teacups

    Teacups Approved members

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    Those were ds's numbers last night at 2 and 5 a.m. and this morning around 7:30.

    We've been dealing with nighttime highs for so long that I've completely forgotten what to do about an 87. I opted for a whole grain cheese sandwich cracker (4 carbs) which gave him the nice little rise. FTR, he was 140 before bed. He had about 3 oz. of milk as a bedtime snack. No unusual activity during the day.

    I know *YDMV* but I'd like to know if you might've done the same thing or if you'd have been comfortable letting the 87 ride. If you wouldn't have given food, would you have retested more frequently?

    TIA!
     
  2. JeremysDad

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    The problem I see with 87 is that, like all BG tests, it's only a moment in time. Is it 87 and going down or is it 87 but it's on it's way up? That's where a CGM is so handy. Without a CGM, I would have erred on the side of caution and done what you did. It's always better to be a little higher (87 and going up) then 87, which is fine if his BG is stable but if it's on it's way down, that's not good.
     
  3. Teacups

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    Thanks for your input. We'll be talking to the Endo about a GCM at our next appt for that very reason. Plus, ds sleeps lightly and wakes up for testing. After reading all the positive comments about them here, I think it's worth pursuing. :)
     
  4. dejahthoris

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    For an 87 in the middle of the night I would give a small apple juice box and check again 2 hours later. If the trend continued of night time near lows I would consider lowering Lantus a smidge. This actually just happened to us for a few weeks, some night time near-lows - I gave bigger night time snacks and lowered lantus .5 point, which worked. I attributed it more activity during Springtime.
     
  5. monkeyschool

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    I usually wait about 30 min or so if it's close to a dinner or snack to see if the number is climbing. If I find it climbs I test more frequently, but don't treat. If it is the same or lower I give a snack. Right now we are going through a couple of days where we just keep getting low numbers, so I am checking frequently at night and during the day.
     
  6. Teacups

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    We've had the opposite issues... highs! Just upped Lantus .5 several days ago. We were ready to go up another .5 but I think we'll stay where we are. Hard to find that happy medium sometimes. :cwds: Oh, and for us, a juice would send ds too high. I actually had a tab in hand but decided on the cheese cracker instead. I felt like he needed something to carry him through. And since I was unsure what to do I thought the cracker would be a mix between a fast acting carb and doing nothing. Hard to know!
     
  7. Teacups

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    I feel like we've been checking a lot more frequently too. Must be the age of 12~! :)
     
  8. JeremysDad

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    There seems to be quite a few new CGM users of late...perhaps because we are one of them and I have noticed a lot of CGM-related posts. It's an indispensable tool. If you had a CGM and saw 87, you'd be able to see what his trend was and make a determination about giving his some carbs based on that trend. You'll sleep a lot better at night knowing that the CGM is constantly monitoring your child and will let you know if his BG levels exceeds set limits.
     
  9. BrokenPancreas

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    :cwds:I would have done the same thing.
    I like her to be around 130 when she sleeps
     
  10. dejahthoris

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    130 is my golden night time number too. When it pops up on the bg monitor it glows and I hear angels! Hee hee
     
  11. Teacups

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    So you're doing MDI's w/ a CGM? Just curious as to how that's going since that's what we'd be looking at for the time being. We also homeschool. :)
     
  12. mom2two

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    No way would I have left an 87 w/out the CGM and on lantus!! IMO you did the right thing!
     
  13. mom2two

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    I know a few people who started out with a CGM then eventually pumped as well. If I had to do it all over again and knew what I was doing :eek: I wouldn't have left the hospital w/out a CGM!
     
  14. Heather(CA)

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    In this situation, I would have given 4oz. of milk because he had already dropped more than 40 points.

    How long after his last fastacting was the 140? What is his current Lantus dose? and, where on his body do you give it to him?:cwds:

    BTW, there is a way to know whether they are going up or down without a cgm. I do this when Seth is close to 100 at bedtime. I test his arm AND hid finger. Because the finger is about 10 minutes IMO more accurate...If the finger number is lower, they are headed down, if it's higher they are heading up, if it's the same (Yes, I have had this happen) then they are holding steady. :)
     
  15. Christopher

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    Or there is another way, just test initially and then test again in 15 or so minutes. That is what I do if I want to know which direction the bg is going.

    I routinely leave numbers in the 80's at night, but that is because I know I am going to be checking later, so I am not worried about it.
     
  16. Heather(CA)

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  17. dejahthoris

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    Nope, just a regular old freestyle lite bg monitor
     
  18. Teacups

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    We had an early dinner of about 60 carbs for 4 units --4:30ish for the Novolog. (Ball game at 5:30 for ds#3!).

    Lantus is now @ 11.5, given @ 9:00 p.m. which is about when ds tested 140bg. His upper thigh is the only place where we give it.

    That is a neat trick about testing. Learn something new every day!
     
  19. Heather(CA)

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    OK, so if I have this right...

    His last fastacting was at 4:30pm and it was his brothers bb game, not his right? You stated that he did not have any extra activity?
    9pm he was 140
    2am he was 87 (This is too big of a drop)
    If that is correct, his Lantus is too high. Lantus is normally changes by 1 unit increments unless you are dealing with a young child. But, in this case you might want to try 11 units, then if he is STILL dropping more than 40 points...Drop it to 10 units. The upper thigh is probably the second best place for Lantus, but is there any chance he would let you give it in the bootie?:cwds:

    The Lantus is too much, but keep in mind that when you lower it, you may need to change the dinner ratio to give a little more insulin.
     
  20. Teacups

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    Yes, you have it right! Younger brother's game, no activity for ds12.

    No bootie allowed. Tried it. It's the few times ds has cried over D.

    But we really don't want to lower Lantus... we're finally seeing good morning and daytime numbers after a trend of highs that looked awful on our Contour chart. I was shocked at how high he'd been in April compared to March. Dh kept wanting to wait it out, wait it out at 11 units.... we finally changed to 11.5 and have seen improvement.

    I'll add that it was a light bedtime snack last night as we've feared that has been the culprit for higher nighttime numbers. Typical snack would be half mini bagel (5g) with peanut butter. Or a few crackers w/ cream cheese. Or milk and a vanilla wafer to equal 10g. So the small amount of milk may not have helped last night's numbers. We'll keep it at 11.5 tonight, increase the snack and see what happens. :cwds:

    I've thought about splitting the dose but don't really know enough about it and the CDE didn't jump on the idea when I asked.

    Ds isn't big on a pump, but if it could help us manage things a bit better, we may need to reconsider.

    For now, we're just doing the best we can and testing more often than usual (due to highs and lows). Finally have the confidence to correct even if it's under 250 at night rather than letting him ride.

    I appreciate the feedback. I really do. Thank you for taking time to share your thoughts! I'm curious to know if you have any new comments based on the general type of info I've shared here. I know it's hard since I'm not giving concrete numbers, but I think it's enough to get the gist of it. Or I hope it is. :)
     

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