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Back on shots and I feel diabetes dumb!

Discussion in 'Parents of Children with Type 1' started by fdlafon, Jan 27, 2011.

  1. fdlafon

    fdlafon Approved members

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    Jordan went to the endo on Friday, for what we thought would be his last appointment with this pedi endo @ Riley (which I adore!) Didn't end up being his last appointment. Anyhow . . . So she's talking to him and asks him why she is seeing some inconsistencies in his log (downloaded from his pump) and he tells her he is tired of diabetes. :eek: I felt terrible!
    So, by his own choice - He is back on shots for a trial run to see if mixing things up will help him any.

    His A1C was down .2 from 8.2 to 8, but she would like him to be around 7. She challenged him to get to 7 by his next appointment in 3 1/2 months.

    So, we switched to shots on Saturday morning, and through the weekend he had great numbers! :D A couple moderate lows, but I think it was just getting back into the swing of things.
    Now, this week his numbers have been creeping up already, and he woke up at 297 this morning! He had baseball conditioning early yesterday morning, so he was tired and went to bed by 9:30 lastnight, so I know he didn't snack on anything and forget to bolus.
    He corrected along with his breakfast, but I asked him to call me at lunch if he was running high again. My problem is, It's been 2 years since we were on shots, and I feel like I have forgotten everything!!!! I don't feel like I can help him without having to call the doctor, but if he is running mildly high through the day, then wakes up with a 297, wouldn't it be basal? I feel stupid!

    Lantus @ 7 am: 19 u

    I:C ratios:
    B = 1:15
    L = 1:20
    D = 1:15
    Snack = 1:15

    Correction factors:
    BS - 100 / 50
     
  2. Nancy in VA

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    It could be that now you've had time for the Lantus to start kicking in that you are seeing he needs more. Could the baseball have caused a delayed adrenaline high? I know when we transitioned from Lantus to pumping, the I:Cs and basal changed, I would imagine its the other way around too
     
  3. hdm42

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    I usually give it a couple of days to see if there's a pattern. If I see consistent highs throughout the day, then I up the lantus.

    When is he doing the lantus?
    We do lantus in the morning to avoid overnight drops, so wake-up numbers are not an indicator for us.
     
  4. fdlafon

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    lantus is at 7 am
     
  5. wilf

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    It would be basal.. I'd start upping by a unit a day until he drifts back into range.

    If you've not been testing nights you'll need to do that while adjusting Lantus.

    Good luck! :)
     
  6. fdlafon

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    He just called from school and his lunch bg was 353. GRRRRRRR . . . .
     
  7. Daniel's Mom 1993

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    We found that when we went back on Lantus we had to split it - if he takes it all at night he drops too much but if he takes it all in morning he drops during the day and he is high at night and once he woke up high it was hard to break the cycle. Splitting did the trick. He always has a big peak about 4-5 hours in..I have been told he might not if he would take the shot in his butt - he won't do the shot there so splitting the dose worked for him.
     
  8. hdm42

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    sorry, duh, should have seen that in your original post. snow on the brain today. :cwds:

    sorry about the call from school. frustrating for both of you, I'm sure.
     
  9. fdlafon

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    We will up the Lantus tomorrow I think to 20, and check throughout the nights until I am comfortable. He'll be ecstatic about that I bet, but I don't like these numbers . . . . Thanks for the advice. I do appreciate it. :)
     
  10. dk10

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    I've seen very high readings in the morning sometimes after a low rebound. Sometimes that happens on a very active day. Usually a low re-bound for my daughter takes huge bolus corrections to bring the reading down to normal (a normal high gets corrected pretty quickly on the other hand). Just another possibility.

    Since you plan to test through the night, you should be able to spot the reason. But usually it does take 2-3 days to settle down, so you may want to test over at least a couple of nights.

    Good luck!
     
  11. SarahKelly

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    Some don't do a 50/50 split either. TJ does 2/3 of his lantus in the AM and then the 1/3 at night. Also, he ALWAYS has highs after extremely competitive sports and just corrects them as the come otherwise if he anticipates and treats them ahead he goes low (figures with d, right?!)
    Just an insight from my hubby :)
     
  12. TheFormerLantusFiend

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    Shots shouldn't be too different from pumping, I don't think. You raise the Lantus if there are highs all the time (and you may need different basal doses for weekends v weekdays) lower it if there are lows not close to eating.
    You bolus the same.
    You can figure out IOB to prevent stacking or simply space shots, your call.

    What feels so different?
     
  13. fdlafon

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    I just feel like I was on top of things the first go around with shots. When he started pumping, life seemed easier (to me) because I knew he was getting his basal, and I could check the pump to see if he bolused.
    I know that it shouldn't be much different, but it is when I question whether he will remember to take his Lantus if he is away at baseball conditioning, because it is new to him again. AND, this time - his dr has him taking his lantus in the morning, rather than at 9pm at night like before.

    A part of me wonders if he forgot to take his Lantus after baseball on Wednesday morning, but he assures me he did. ????
    He ran high every reading yesterday, but one - the last check before bed, But then ate a helping of mac & cheese and woke up at 390 this morning. He corrected, and I called the nurse to see what his lunch number was and she said 91. So Thats a relief.
     
  14. denise3099

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    May I suggest CGM? I know more and newer technology is not always the answer, but if you are looking for new and interesting ways to shake things up a bit and renew interest in self care, maybe cgm might be a good direction to go in. Just putting it out there.

    It's hard to go back--like starting over. But I really have to applaud your willingness to go back to mdi. You put your son's need for a change over your own need for comfort and familiarity (not to mention being able to check on him via pump records). That was really big and brave of you. Awesome mom! :)
     
  15. TheFormerLantusFiend

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    OK, so it sounds like the hard part of shots is the lack of an automatic log (which makes total sense- that's probably the hardest part for me, not always being sure of when and how much insulin I've taken).
    As far as I know, there are two insulin pens that remember the time and amount of the last dose for you- the Humapen Memoir (which I have seen) and the Novopen Echo (not available in the US yet). There isn't one that holds Lantus.
    I think having to take Lantus after baseball is a bad place to schedule it because of the ease of forgetting (I'd forget). It should be right after waking up or right before going to bed for a teen because those are things that happen. At home, usually. And if baseball practice makes waking up early or going to bed late, well, taking the Lantus an hour or two late sometimes is way less of an issue than forgetting.
     

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