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Dealing With Rapid Increases in Insulin Needs

Discussion in 'Parents of Children with Type 1' started by sszyszkiewicz, Mar 9, 2015.

  1. Sarah Maddie's Mom

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    Just know that basal rates of 40, 50, 60 u are not uncommon in pubescent Type 1s, and the higher the dose the harder it is (in my experience) to get the margins right. I think 11-15 are the hardest years, the years when folks no longer brag about their kids A1c :cwds:
     
  2. sszyszkiewicz

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    Do the basals eventually drop back? Is it as sudden as they rose?
     
  3. Sarah Maddie's Mom

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    I can only speak for my experience with one teen, but it seems to be a gradual decline in TDD, and yet her last A1c was the lowest its been in years so things seem ( at 17) to be leveling off a bit :)
     
  4. wilf

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    Everything calms down when basals are set right.. :cwds:
     
  5. Phyllis

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    Several things occur to me. First I would replace the insulin vials. Even if the expiration date is good, if the vial has been open over a month the insulin may have lost some potency. Also, it is quite possible that pubertal hormones are increasing insulin resistance. I would start with newly opened vials and then adjust the dose of basal upward slowly in small steps if needed. Even small increases can make a big difference. If puberty is a variable, the insulin to carbohydrate ratio may also need adjustment. If you have written or computer records of these results, your diabetes team may be able to help you with specific recommendations. You will figure this out.
     
  6. sszyszkiewicz

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    Thanks Phyllis. Sounds like you have been at this a while!
     
  7. rgcainmd

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    The problem is, puberty hormones are not an all-or-nothing phenomenon. (Or maybe it's just different with girls.) Although my daughter hasn't yet gotten her first period, her hormones are all over the place from day to day (with nothing even closely resembling the cyclical pattern most women see.) With no apparent changes in diet/exercise/daily schedule or insulin regimen, my daughter will be in the 200s one day and we'll be dealing with multiple lows the next day. I owe it to the fact that my daughter uses a pump (and I am constantly setting temp basals) that her A1C is still in the 6s. Couldn't imagine riding this roller coaster without a pump and a CGM.
     

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