Discussion in 'Parents of Children with Type 1' started by MyTMax08, Nov 20, 2011.
Wilf, can you explain this please, thanks.
I think her concern was whether or not she should have gone ahead and corrected knowing that in say half an hour he'd be eating, or if she should have waited to correct with his lunch bolus.
Yes, I know, that's what I meant, I would have combined the correction with a conservative guesstimate of his lunch carbs since it was so close to eating time.
I probably would have waited for the lunch bolus, if it were a 1/2 an hour, because with a blood sugar that high, the best practice would be to wait 30 mins prior to eating to give the insulin a chance to bring the blood sugar down. If it were an hour or more, I would have given a shot.
okay, just making sure. That's how I would have done it, too, but with a Church luncheon, it might have been harder to pre-bolus. At least for us it would have been.
Without a doubt, if it were me I would have peeked at the choices and just done a conservative guess, then done a second shot after if I were way off (mostly in the dessert area!). So I would have done the correction + a prebolus for what I thought lunch would be (conservative guess) then probably a second shot if I were off and he ate more.
That would be a good plan for sure. The deserts get me every time, lol
Now I'm confused, shouldn't the correction/lunch bolus be given ahead of time to give a chance to work before food ingested??? Why would you wait if lunch was only 30 minutes away given that he had a high blood sugar?
Prebolusing isn't something we've really refined (mostly because he eats ALL the time), so I'm curious what you mean here.
Sure. Page 131 of Type 1 Diabetes by Hanas states:
"A temporarily very high blood glucose level (450-550 mg/dl) can often be caused by not drinking enough. If the person is able to pass plenty of urine, the blood glucose can go down to approximately 360 mg/dl without extra insulin. If you find your BG level is very high when you are feeling fine, therefore, it may be a good idea to drink plenty of extra water or sugar free drinks.."
So he's saying you can get a drop of 100 to 200 points just by rehydrating, if the child is dehydrated..
I worded it wrong. If lunch was truly only 30 minutes away, I would have bolused; if it was 40 or 45, I might have waited an extra few minutes to reach the 30 minute prebolus. If it was an hour away, I would have corrected and then given a shot later.
Your thread is entitled, "Don't know what to do?" I made suggestions on what you should do. Sorry it wasn't to your liking.
Sarah...I apologize, I did ask that question and I got it...towards the end of the conversation...I now have a better grasp on when to use correction, got my answer for my question about deciding whether or not to give a correction or feed him and do insulin that way, I have gotten ideas on what else I could offer (out of that came things that I would never ever do, and things that will be great to try). It's not that it wasn't to my liking, I just don't see why there has to be words like Endo pushing too much water (not in that exact terminology was used) bc it isn't him, it is me and our family. We have had a major lifestyle adjustment since February (I have lost over 150lbs) and our diet is pretty important to us...I don't overly focus on water for our son, nor does my husband. We just ultimately want him to enjoy something that is better, much better than the other alternatives so many use. We just choose to do things differently and in this post I mentioned water. So, my deepest apologies if your sarcasm came from what I shared from my heart (which was to never intend that it wasn't to my liking). I appreciated each thought and will take what I think our family can benefit from and be grateful for meeting others in the process. Sorry ~ Melissa
We have never given insulin 30 minutes before his meals. When I inquired about it the dietician told me that because Maxim doesn't take regular insulin than it usually needs to be 30 minutes prior, in our son's case (Humalog) he can be adjusted to fit the amount of food he'll be eating. So we give his shots just before he eats. In the case of the high blood sugar, I was stopped in my tracks because we have never had to make a decision (since the day of his dx) on what steps to take at this high of a blood sugar. Thanks, what you've shared has been sooooo helpful. ~Melissa
That is wrong. Prebolusing with Humalog/Novalog has an amazing effect on blood sugar and the A1C. We 'try' and prebolus based on what her BS # is prior to eating. This gives the insulin a chance to get to work prior to food digestion.
I suspect he had active insulin and thats why it brought him down. How long after eating and getting insulin was his first check (the 400)?
As for the drinks....my DD loves Green Tea or the Mio flavors you can add to bottled water (fruit punch is her favorite). Lipton has a diet green tea with a mixed berry flavor that is really good. Maybe he would like these better than plain water. My DD is not big on plain water either so I understand it can be a challenge to find something sugar-free she likes.
We don't normally do 30 minutes either, but if I knew a meal was coming, and he had a known VERY high blood sugar, I wouldn't hesitate to prebolus by 30 minutes. In fact, on my fridge I have a chart from a book that shows how soon you should prebolus based upon pre-meal blood sugars. A pre-meal number of >249 SHOULD prebolus by 30 minutes according to the chart.
I do encourage a 15 minute prebolus with my son as it has been shown by research to be of great advantage. He uses novolog. Prebolusing allows the insulin and the food to be better matched, vs food rising blood sugar before insulin has time to act.
Definitely do some research on prebolusing, as it can really make a difference in post prandial numbers, as little as 15 minutes before the meal can really level off numbers significantly.
This off topic, but caught my eye. Congratulations on losing so much weight and for making the changes at home that will allow you to keep the weight off!
Have you tried adding the flavored Stevia drops by Sweet Leaf into his water? We do it occasionally. There are many flavors available. It's much healthier than diet pop!
Our correction unit is different during the day...we correct at 200, .5...at night manager had correction at 300 - .5....but decided best to correct at 250..So last night at bedtime he was 239...I corrected .5(first check was 270) so decided to correct.. at 2am he was 112..this morning 99...so in this case correction helped..
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