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Guidance and help please.

Discussion in 'Parents of Children with Type 1' started by Caynuns mom, Apr 15, 2007.

  1. Caynuns mom

    Caynuns mom Approved members

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    I posted this on the General discussion when I probably should have posted it over here.
    My son has been Dx diabetic for a year now and this whole time I've been looking for support groups, classes, parents of D children but have not had much luck finding help and support in my county. I finally got word from JDRF in New York city that this forum could help and boy has it opened my eyes to how much I dont know about my sons disease. I thought I was pretty well versed in diabetes growing up with a diabetic father. I'm versed enough to be maintaing my sons A1C level @ 7.7 which is still a little higher than it should be but not too bad for newly diagnosed according to our Endo. I have been reading through alot of the different topics like Illness and mixing glucogon and insulin, meter readings of 120 two hours after eating, keytones with low blood sugar? I dont get those kinds of readings 2 hours after my son eats (not even close) is it a pump vs injection thing? I didnt know he could have keytones with low blood sugar or is that only during illnesses? If the glucogon is used in emergency situations to bring a low up and insulin keeps the levels from being to high are they using them together to maintain a certain level during the illness? I havent encountered alot of these things and I'd like to be prepared just in case.
    I obviously need some support and guidance.
     
  2. melissabeth

    melissabeth Approved members

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    Hi Caynun's Mom,
    Welcome!
    I'm a little confused about your post- Glucagon is the emergency-only glucose injection, so I'm not sure when you would be "mixing" it with insulin? Did you mean that glucose and insulin mix in his blood?
    As far as having keytones and low blood sugar- I'd like an answer to that question too- I think I've read that it's possible when kids are sick, but I'm sure someone with experience will chime in...
     
  3. badshoe

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    Hey welcome to the board.

    Ask away you will get a number of different answerers, remember YDMV (Your Diabetes May Vary) so don't assume we are brilliant or anything.

    Mixing glucagon and insulin, good get on your part to be confused. No it wouldn't be done and you probably picked up on that in your training even if you don't remember it.

    I can think of two things you may have read about mixing.

    One insulin the other glucagon. Some folks mix insulin in the needle before injection, typically clear and cloudy, (aka fast and slow, aka basal and bolus, keep in mind at all times the vocabulary of diabetes was designed to confuse the heck out of newbies.) Glucagon must be mixed before use. It is only for a low emergence and we all hope and pray none of us ever get to that point. I have seen it used once in my life by an EMT on a guy who collapsed in our parking lot at work.

    As for two hour after eating BG. YDMV. (Who said that? They are BRILLIANT! :p)

    My advice is not to worry about other people's numbers. Worry about what you are doing at this stage of your journey with diabetes. Are you comfortable testing? how about you son, how old is he? what stage of doing stuff himself is he at, BG test? shots? Are you comfortable making changes to your insulin levels? You on a sliding scale?

    It is real easy to get the guilts with this thing rather than focusing on our successes. Compairing numbers as if YDM not V is a path to the guilt.

    So here are some successes for you I read form you post.

    1) You care
    2) You seek out help to learn more (the single best trait in any human being)
    3) You found JDRF
    4) You found this place
    5) Your endo says you A1C is good
     
  4. MrsBadshoe

    MrsBadshoe Super Moderator

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    Welcome glad you found us.

    Like my wonderful husband just said...YDMV (your diabetes my vary) definately use this site for information collection.

    On thing you might want to talk with your endo about during your next visit is changing his insulin regiment. Using NPH can cause lots of highs and lows. You must constantly feed the insulin with a rigid eating schedule. I'm sure something you must find difficult with a toddler. I know both my older kids 7 and 9 at dx found eating on a schedule difficult while on NPH. Either the pump or a combination Lantus/novolog regiment you might find easier. I would read up and ask question about both. They both have pros and cons but I personally feel my kids on pumps have much better control then on NPH.
     
  5. Caynuns mom

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    My son is 3 he is on a sliding scale (novolog)and yes sometimes I do have to mix his insulins depending on his readings. he can and does his own finger pricks with a little help but lots of supervision from myself. He has trouble getting the blood onto the test strip. I'm very comfortable with testing and luckily for me my son shows signs of lows and highs (all in the way his eyes look).
    The fact that the emergency glucogon has to be mixed before injecting may be where I got confused with reading the post that talked about it.
    I did read some posts about parents being discouraged with #'s in the 200's 2 hours after their kids had eaten and they were saying that it was unusual for them because they normally had these great readings like 120-150 I'd sure like to know how they are doing that!
     
  6. MrsBadshoe

    MrsBadshoe Super Moderator

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    My kids have been D for 3.5 and 2.5 years respectfully, they both are on pumps and we still have many times that 2 hrs post meal they are above 200. We have been able to fine tune carb ratios and Insulin sensitivity factors and have been able to get a higher percentage of the numbers under 200.

    For a while I felt the same as you. I finally realized that you can't compare you D with others. Everybody is different and every BODY reacts differently to food and insulin.

    You just need to find what works for you. You will learn though that different insulin regiments like I mentioned previously give many diabetics different often better results. So, it is always a learning process.
     
  7. Caynuns mom

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    Yes a constant learning process as I'm finding out! I hear the pumps are the way to go but I do worry about my son pulling at it and possibly taking it apart like he does everything else! Did I mention he IS ALL BOY! lol
     
  8. MrsBadshoe

    MrsBadshoe Super Moderator

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    There are many parents of toddlers who said they felt the same about there kids ripping it off but the posts I have read have said that most don't even bother it. They definitely prefer it for fine tuning and letting a toddler eat when they are hungry vs. by the clock.
     
  9. Caynuns mom

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    I just received a list of places to try to possibly get a demo of the pump from the post I made on the General Discussion. My son will eat his breakfast or his lunch then like 2-3 hours later he will want something else (like most toddlers) well 2-3 hours after his meal he is usually high so my instructions for this is to give an injection of the sliding scale then give a snack so now my son is associating an in between snack means another shot!
     
  10. MrsBadshoe

    MrsBadshoe Super Moderator

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    Definately makes sense to me that I toddler would associate eating with shots...Sorry you have to deal with that.

    I definitely call the pump companies and talk about the pumps. Also, you will find that not all endo are pro pumping. I can't for the life of me figure out way. They aren't the ones that have to deal with this every day. It seems it's easy to say you have to do shots but try to live in my shoes (or yours). If your endo is completely against putting you on a pump and you feel you have the knowledge to have decided that is the best therapy for your little one...you might consider changing endos...But most drs are infavor.

    If you weren't given this link here it the link on CWD that has lots of great info on pumping..

    http://www.childrenwithdiabetes.com/pumps/links.htm
     
  11. Caynuns mom

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    Just a quick thank You! You are a great help!
     
  12. MrsBadshoe

    MrsBadshoe Super Moderator

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    I sent you a PM...did you get it?
     
  13. Carrie

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    Hi, Nikki...

    I, too, have read on the board recently about giving a small dose of glucogon and insulin. Unless you've been at this for a while or directed by your endo, I wouldn't try it. :eek: I'm saving that baby for an emergency, and hopefully I never have to use it!

    Our daughter is 4 and at her 3-month check-up a couple of weeks ago, her A1C was 8.8 and our endo seemed pretty pleased. I would say that 7.7 doing MDI is a wonderful number!

    As far as the two-hour after meal reading...we usually don't check that soon after eating. If we did, I know she would be over 200. Our endo recommends checking at least four times a day. When first diagnosed, I would get myself worked up reading that other parents on here were checking 8-10 times a day!! I guess it would matter how often you could correct for a high. We are still only instructed to correct no more then every four hours. I know that will change as she gets older and the control (2-hours post meal) will probably get better.

    The pump is a good thing (if he doesn't tear it apart:D ) for those grazing eaters in your life. When on MDI, it would never fail that she would get done eating and 10 minutes later she wanted something to eat. Very frustrating! Chesse, popcorn, and pickles get old after a while. :( She, too, was starting to associate eating with shots. That's the nice thing about the pump. Everything she puts in her mouth we can bolus (what would be like giving a shot) for. Instead of holding of eating until the next meal or offering "free" food, they can eat whenever they want. And...being that they're eating all day long, I think it's harder to get accurate readings.

    Keeping asking questions. There are a lot of us newbies on here that need to learn right along with you. :)
     
  14. badshoe

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    We have seen this as part of the lovely sick days deal. The pukes are part of life and as if it wasn't bad enough it screws up D kids. No food going in means the body lives off fat. Ketones are a by product of burning fat instead of glucose. With no carbs bg stays low so you cant give insulin to break the ketones.

    We had to take DD into the hospital for it once. They were very timid about hanging some glucose IV. Turns out our endo lives near by and now we have permission to page him and get a pro in to help out if we need to go that route again.

    That another thing about diabetes - no mater how bad something is - say the barfs - D can make it worse.
     
  15. Caynuns mom

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    I so far and knock on wood have not had to deal with any barfing yet but I was told if he barfs I am to call the on-call endo immediatly for instructions. I think its great that USF endo group has on-call but I would like to be well informed of what the instructions might be prior to the situation. I'm sure my nerves at that point might be calmer and I'll be less likely to fumble with the instructions!
     
  16. Boo

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    I am happy to say in 3 years with D, my son has never had the "pukes" (I am sure that I just jinxed myself). Actually we just recently, within the past 2 months, had the first situation in which he didn't want to eat...he was getting sick and also had braces put on that day.

    I still dread when that day (of the barfs) will come!
     
  17. Mama Belle

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    Welcome!!!

    When you talk about "mixing' glucagon and insulin, you are probably referencing the other thread where we were talking about the mini-dose glucagon combined with a follow up shot of insulin during a stomach bug. This is a preferred treatment by some endos to avoid a trip to the ER when ketones are elevated and blood sugars are low. If a child can't hold down food or drink enough fluids due to vomiting and BGs are low, insulin cannot be given to turn off ketone production. This is where a mini-dose of glucagon comes in. The glucagon raises the BG enough to allow a person to give an injection of insulin. The insulin turns ketone production off. You should never do this unless specifically directed to do so by your endo!

    As other have said, yes, a D person can definitely get ketones with a low BG, particularly when sick with the stomach flu. With any type of stomach illness we always test ketones at least every 2 hours regardless of BG.
     
  18. cbanks

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    That was a really good answer, Good job, You robbed the words right from my mouth!
     
  19. badshoe

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    Thankd Mama Bell.

    I stand corected on the VLD glucagon thing. It is in the study phase.

    Here is a press release of a firm workin on phase II trials:


    The part where I called myself brilliant for my YDMV comments in particular no doubt! :D
     
    Last edited: Apr 17, 2007

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