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At what point do you assume insulin is off??

Discussion in 'Parents of Children with Type 1' started by KHS22, Dec 12, 2013.

  1. KHS22

    KHS22 Approved members

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    So my little one is still honeymooning like crazy - on minuscule amounts of diluted insulin (TDD of around 1 unit)

    Her sugars have started creeping up the last week, starting to have high teens before meals, but she corrects nicely back down to target. But, today - she was 16 before lunch, 19 after lunch - so I corrected. 19.8 before dinner - so I bolused for dinner and corrected. and now at bedtime is 22.3!! So I just corrected her with some full strength humalog of my husbands.

    I'm wondering if this is just her sugars creeping up/coming out of honeymoon, or if the insulin is off! Its diluted, but is supposed to be good for another couple weeks. I guess the correction with the regular insulin will tell us the answer???
     
  2. obtainedmist

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    We've never had insulin that was bad. Hope the numbers get better! :cwds:
     
  3. Sarah Maddie's Mom

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    Insulin being "bad" is the very last, last thing on my trouble shooting list. 11 years and maybe, just maybe, one instance and it was, if I recall correctly, insulin that had been blatantly and ridiculously mishandled.
     
  4. KHS22

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    Huh - good to know. I assumed it was a 'common' thing the way that the clinic seems to obsess over how you handle insulin.

    So more likely that this is just her coming out of her honeymoon??
     
  5. skimom

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    Could be the honeymoon starting to fade......any chance she is coming down with a bug? Or getting into some sweets? We have only had insulin issues once and that was due to leaving it out on a really hot day....
     
  6. AliciaM

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    This has been happening to me as well. Someone also suggested to me it could be me getting sick but I feel fine and I sincerely hope I'm not as I leave this weekend for a vacation to the bahamas. At this point I'm not sure if I'd rather it be my honeymoon ending or me being sick..:(
     
  7. Sarah Maddie's Mom

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    It helpful not to think of the "honeymoon" and being on an "on-off" switch. I think my kid's pancreas was "helping out" for about the first 5 years - though if anyone had suggested at the time that she was still in "honeymoon" I would have pitched a fit. ;)

    Sometimes D just throws you a bunch of curve balls and all you can do is react to what you see before you and leave it to hindsight to comprehend the bigger picture.

    Hang in, it will most likely pass.:cwds:
     
  8. kiwikid

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    Is diluted insulin more likely to go 'off' than straight insulin? I would expect that it could get contaminated in the dilution process ?? :confused:
     
  9. quiltinmom

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    Well, I don't think you're going to see the honeymoon "wear off" in a single day. So one day of weird, high numbers doesn't mean anything regarding honeymoon, in my opinion. But the slow creeping up would mean something--either growth spurt, less help from her body, or whatever. Whatever it is, it doesn't really matter; it just means she might need a little bit more insulin. If she's high before meals (depending on how far apart meals are) I would think that points to an increase in basal needs.

    As for bad insulin....just after DX we used the first bottle of novolog until it was completely gone. (we missed the part about starting a new vial every 30 days. oops.) On the small doses he was on, it took like 4 months to use it all. It worked right up until the very end, though. I've never had insulin go bad either, in the 4 years we've been using it.
     
  10. kirsteng

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    We've only been at this one year, but we have had insulin go 'off' one month... and it wasn't even in the summer. It was October, it was a new vial of insulin (NPH),and we also thought our son was coming out of honeymoon. Every day his needs were higher.. and we were also increasing novorapid as well to try to get a handle on his numbers again. Finally after 2 1/2 weeks of doing that, it was starting to come time to change the vial anyway, so I did it a little early. Lows lows LOWS. He eventually ended up very close to the dose he was at prior to all that mucking around.

    So it definitely can happen - and I wish I'd tried a new vial earlier because it was a LOT of bad numbers for a couple of weeks, then a lot of lows for a week or two to try to get back to normal territory... and all because of one pen vial of NPH. ;)

    We also used diluted NR (now pretty much phased out except for overnight corrections), but never had problems with it. We were careful about its 30 day expiry though, and the need to refrigerate.

    My thought is to try a new vial, at least you'll rule out one variable that way. GL!
     
  11. wilf

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    If you're sure it's not lows/rebounds then it sounds like time to up the basal..
     
  12. missmakaliasmomma

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    I have had insulin go bad before the 28 days. Usually its in the summer but it's happened at other times too.. I don't do anything weird with it either like keep it in my pocket for 28 days straight lol.

    I find a lot of the time my daughters having issues with highs it's usually 1.a basal issue or 2. she's getting sick but shows no outward signs yet.>> It happens to us about 2x a year and when the fever or sickness actually comes out, it all makes sense lol
     
  13. hawkeyegirl

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    In six years, we've had the insulin go bad once, I believe. If you are storing it correctly, it should be a very rare occurrence.
     
  14. Mish

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    Diluted does seem to go bad quicker, and if I recall, we were told to only dilute enough for 2 weeks at a time. But if you're diluting at home and doing it properly, it shouldn't get contaminated.

    But like others have told the OP, bad insuiln is generally the last thing I suspect unless I know the insulin has been mishandled.
     
  15. KHS22

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    Thanks guys. I tried new insulin, just to be sure. Still crazy unexpected highs. I think her needs are just going up up up! My endo said he finds little kids have less of a honeymoon/helping whatever you want to call it period. So we upped her basal today, and she's still 25 by the afternoon! So we are just pretty aggressively increasing what she's getting, testing more often, correctin.g


    Thanks for the inputs!
     
  16. schnoodle

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    I was diagnosed in the very early stages of D, due to family history (similar to your DD.)

    Perhaps, because of this my sugars were extremely labile on injections (similar to your DD.)

    I got a pump approved less than three months post diagnosis because of my unique circumstances.
     
  17. KHS22

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    Thanks schnoodle... we are working on insurance application for the pump right now. However, they are unlikely to pay for it, due to it being covered by the government after 1 year on MDI and decent A1C's. So we are trying to make a case that she can't wait a year...
     
  18. schnoodle

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    One year is not actually a qualifier for those under 18 with ADP. There are many misconceptions about ADP, and I really do not feel like any of the stake holders are on the same page about the qualifications

    See the pediatric application here http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-4446-67E~5/$File/4446-67E.pdf

    Neither the adult application nor the peds applications explicitly say you have to have had D for a year.

    The ambiguity favours the party who did not write the form i.e. the patient and the physician.

    If the physician wants you to have the pump, you will get it under ADP.

    A lot of it comes down to the politics of how the clinic is run, and at some clinics, the CDEs call the shots.

    It is all very confusing, but it is not true that you have to have had diabetes for 1 year to get a pump under ADP.
     
  19. schnoodle

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  20. wilf

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    You're sure there's no lows/rebounds happening?
     

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