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diagnosed 6/13

Discussion in 'Introductions' started by eek, Aug 17, 2013.

  1. eek

    eek New Member

    Joined:
    Aug 17, 2013
    Messages:
    4
    Hello,
    We are in our second month with Type 1. I have some questions now that we've changed from dosing for BS to dosing for BS and carbs.

    I initially thought that our goal was to have consistent blood sugars near our target, which is 150. What is happening though is, my son will wake up at 100 then lunch he my be 140 then dinner 170 and bedtime is typically in the 350's.

    But, two to three hours after his meals he goes up to 350, maybe higher. Today lunch was at 12:30 and at 3 pm he was 446. Are spikes this high normal?

    If we are late for a meal then he drops fast, so the only time we are in target is a brief period of time on the way down from a spike.

    His ped dr. Is not happy at all with this but the endo is saying that as long as he comes down, it's fine.

    My other concern is how far he drops at night. He typically falls asleep in the 300's and wakes close to 100. I'm now afraid to put him to sleep in the 200's fearing a 200 pt drop.

    Also, he still seems dehydrated. The Ped said its probably because he's high so often. Should the endo be addressing this? Will this be an emergency eventually?

    Thank you, I have so many more questions...

    He's on Humalog and lantus
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Joined:
    Sep 23, 2007
    Messages:
    12,521
    Hi and welcome. Sorry you had to join us.

    Managing a Type 1 kid can really, really hard at first - it's not easy being a pancreas.

    Post meal spikes are normal but from what you've written, I'd say that you're seeing too much glycemic variability. Your endo should be working with you to adjust things. You will never have perfectly flat numbers, but there's no reason for your child to be in the 300-400s every day.

    I highly recommend Ragnar Hanas' book, "Managing Type 1 Diabetes" - any recent edition will do, it's a book you will reference for years.
     
  3. nanhsot

    nanhsot Approved members

    Joined:
    Feb 20, 2010
    Messages:
    2,626
    Regarding the night drops, your son may be in honeymoon period, the time where, once given a little relief with injected insulin, the pancreas start to work again. The body will always try to stabilize at or near 100. One of the commonalities of honeymoon is that the child will often wake at or around 100, even if entering sleep at a much higher number.

    I would definitely work with your team on this spikes. Are you giving the insulin before the meal (prebolus) or after? Giving the insulin before eating can help with those spikes. It also may be that his night time meal insulin needs are higher than the other meals, it's not uncommon for the ratio to change by meal/time of day.

    All that said, spikes are common. Testing 2 hours after a meal isn't really all that useful of information, IMO. If the spike is still there at the 3 hour mark then I'd worry. We actually DO see spikes like that most days, and as long as they are brief we don't worry a lot. It really depends on how long the spike is lasting.

    The dehydration would concern me, but for brief spikes you won't see the effect your pedi is referring to, only really for stubborn highs and ketones, which won't happen with brief post meal spikes.

    Your questions are good ones, so don't worry about having lots of them! This is a crazy disease with lots of changes, glad you found this place and jumped right in! Welcome to the club that no one asked to join.
     

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