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Do highs always have to come after lows (vent)

Discussion in 'Parents of Children with Type 1' started by Sherry Wendi's Mom, Aug 19, 2009.

  1. Sherry Wendi's Mom

    Sherry Wendi's Mom Approved members

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    Last night's bedtime check was 88. Dr told us not to send her to bed unless it was above 90. Gave her 7 gm fast acting carbs followed by about 8-9 of longer lasting carbs. I didn't wait the fifteen, because it was already 10:30 and my darling girl was very tired. Tested about ten minutes after the first test and was up to 110. Went to bed. Got up for 2 am check and 349!!! :mad: I don't get it. Every low she's been having, I give her what I was told (except last night since it wasn't a "true" low) and end up with her sugar sky high. I know we are early in the game, but I really wish I could get a handle on it.
     
  2. StillMamamia

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    D is very frustrating to say the least.:(

    I think you may have to do some trial and error with the corrections of lows or end of range BGs. I always tend to over-treat, then end up chasing highs.:rolleyes:
    Really hard stuff to do when they want to sleep.

    Hang in there.

    PS - how's the issue with the fear of going low? any progress with that?
     
  3. Melissata

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    The problem is that their liver can kick in some glucose as well. We solved the problem by treating with far fewer than the 15 carbs. For a long time we used just one glucose tablet to treat most lows and she stopped spiking afterwords. She is now on Metformin, so we need to give more because the Met affects the glucose put out by the liver. One gram of glucose can raise the bg up 10 to 20 points for a child. Add that to the liver response and you have the reason for the rebound. There is a list in the Bernstein book that goes by body weight. I don't agree with much that Bernstein says, but that little tidbit was worth the cost of the book and much more to me! The roller coaster of lows and then highs stopped immediately after I stopped treating with the 15 rule.
     
  4. Sherry Wendi's Mom

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    She still "feels" low at times, when she is not. But I think it has to do with her body's response to a drop rather than a fear. In the many times that she actually had and responded to a low, she responds very confidently and without fear or panic. This included a low at the swimming pool. She quietly got out of the pool and told her daddy that she felt low. Sure enough it was a 59. I am proud of how she is handling this.:D
     
  5. StillMamamia

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    Awesome!:)
    I think, if she's honeymooning, then the insulin she's producing plus what she's getting, may make they dropping feeling be even more palpable.
     
  6. Lee

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    It could be three things: Either you over corrected the low, her nighttime #'s are out of whack any way, or it was a rebound from a following low. But how do you tell :confused:

    Do you test at night anyway? Are those #'s out of whack?
    Do you know how much one unit raises her blood sugar? To figure it out for my kid, I took a stable # - no IOB - and gave her two quick carbs (smarties) and tested an hour later. So I know that 1 carb raises her BS 5 points on average. So when I correct, I have a better idea of what to give her.

    The other thing it could have been is a rebound. She could have been dropping when you caught the 80, and she could have gone lower.
     
  7. Sherry Wendi's Mom

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    See the imbedded answers above. Thanks for all the advice, guys. You are the greatest.:D
     
  8. wilf

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    Yes, you need to determine how much 1 gram of carbs raises BG levels. This will allow you to avoid overtreating lows..

    What we do here is every 1/2 year or so I will give DD 2 glucose tabs at a time when there is nothing else affecting BG (no IOB, no food eaten in past few hours, no exercise) and then I measure how much she comes up. THis gives me the amount that 2 tabs (8 grams) raise BG and then I can treat as needed when she is low.. :cwds:
     
  9. Ellen

    Ellen Senior Member

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    At age 12 there can certainly be impromptu hormone parties taking place in the body. Also, don't underestimate how much stress plays into things and raises blood sugar. Some things are not always measurable.
     
  10. Nancy in VA

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    I would say two things:
    - The carbs was an overtreatment; and
    - there are probably growth hormones at work around that time of night. We saw spikes like that with Emma not long after she was diagnosed. She came down on her own from them and then about a week later, they stopped
     
  11. Heather(CA)

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    Hi Sherry, you need to do some over night testing. She could be going low again, then rebounding. If it's a steady climb. Try giving her 4oz of milk for an 88. Milk should not send her that high, if it's a steady clinb and she still going high, then she needs more longacting insulin. If she's going low, then the longacting insulin needs to be lowered. Lantus, Levemir, or basals. Whatever she on:cwds:

    I would do the overnight testing before I changed anything, 349 is quite high after being good which makes me lean towards it being a rebound. Test extra between the time of the 88 and the 349.
     
    Last edited: Aug 19, 2009
  12. karliesmom

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    Same thing happened to us last night

    I am glad I read your post, the same thing happened to us last night. Karlie was 65 at bedtime so I corrected, tested, corrected again (that was probably my overcorrection) and at 1 am she was 338. I don't post often on the boards (very little time to do so) but I do read them and it is comforting to know that other parents have the same issues. We have been at this over 2 years and some days I just don't feel like I have a handle on it either. Just wanted you to know you're not on this ship alone. We all go through it. Even those who have been dealing with it a while. :cwds:
     
  13. drewgolden

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    As a Type 1 diabetic, a number in isolation is not as helpful as a series.

    So if you test at bedtime and it's 88 - if you tested a half hour later you would have more information.

    88 - half hour later still 88 - then do nothing right?

    If it's going down, then correct. But know the math.

    15 grams of carbohydrate would raise me 90 points. Each person will be different.

    If it's at all helpful, I try to avoid eating anything after 7pm. And instead of reacting to one test, if the number is not too low or high (which would require immediate action) wait 1/2 hour and see what is happening.

    Based on the numbers you used, it looks like 1G of carb will raise the BG by 17? (349-88=261, 261/15 Grams=17 points per Gram)

    I sometimes I tell other Type ones to keep a log book for just a few days, every carb in, every test result, and every injection. Sometimes it helps doing this every so often to see how our bodies are reacting to the treatments. Sometimes we need to adjust our numbers, and the easiest way to do this is to write it down.

    I hope that helps.
     
    Last edited: Aug 19, 2009
  14. Reese'sMom

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    I have learned that it takes very few carbs to correct a moderate low. I personally like to use grapes (1 carb each, so I can correct with 5 or 7 carbs for a slight upward adjustment when I need to).

    It's all trial and error, so just take every "error" and consider it a learning experience.
     
  15. Emma'sDad

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    Hi Sherry,

    Your Wendi is an amazing little girl. It took me a long time to 'figure this thing out' and went through exactly the same thoughts and frustrations as you do at this stage.... And I didn't even know about CWD for over a year after we started!!!!! I could have used a few words of encouragement after the first month into this. You're doing great and learning as you go. Keep up the good work!!
     
  16. sam1nat2

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    what are her normal nighttime numbers like? Do you know if she typically goes up during the night and then back down on her own?

    If that happened to us, I'd think rebound or maybe dinner hadn't hit yet
     

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