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Help me get it together: Carb counting...dosing etc....

Discussion in 'Parents of Children with Type 1' started by Hayden'sMom, Jan 14, 2011.

  1. Hayden'sMom

    Hayden'sMom Approved members

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    Ok. So I know I need to carb count and dose accordingly... I just haven't learnt yet :eek:

    My dietician gave me a formula quickly over the phone (she thinks I should just adhere to NPH and Novolog and follow the little chart that shows how many servings of fruit/protien,fat etc that a typical 4 year old should eat:confused:). The chart isn't working for us and we have been tweaking our son's insulin pretty much by guessing and looking back on our charts to see what food he is eating and what effect that food has had depending on what his bg was at the time ( THIS IS BEYOND CONFUSING) I know from her brief calculations that 1 unit of Novalog will bring him down 10 and this has been pretty much my base for dosing.... this isn't working... I know YDMV and it will never be controlled... but where should I be looking for help to carb count and figure out how much insulin he needs? Good books or websites??

    I feel like I need a new support team.. this is not working. We finally have an appointment with an endo at the end of the month.. I really hope this will enable us to find new help!!!!

    Also, some of you have referred to "insulin stacking" what does this mean and is it bad? Up until now, I have had to give him insulin with every meal and snack. We have just switched to Lantus and I do not correct him during the night (he will go down too low if we do). However, today I got all nervous about giving him insulin with every snack and I didn't do it... he has been high all day (17-22).

    Any advice on a good starting point. It has been 3 months and I still feel like I know nothing!!!!

    thanks for listening...
     
  2. mommylovestosing

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    Hi! You are doing GREAT. Just questioning everything is a big thing!!

    So, "stacking" insulin, in a nut shell, is correcting for en elevated BG when there is still insulin doing it's thing. When people on pumps are talking about duration, this is what it means. This is an advantage to the pump, over MDI. I'm only telling you this to help you understand, NOT to push a pump! So, let's say you test at 2:00 PM and the BG is 245. So, a correction will be done. Well, at 4:30, he decides he wants a snack. Since it's been over 2 hours, you decide to test him. He is at 185. Okay, so that is still a little high. So, you would want to give him insulin to cover the snack and to bring down his BG. EXCEPT, there is still active insulin in his body bringing that high down! In a pump, most people have the duration set to 3-4 hours. So, the pump would've known there was insulin on board (IOB) and NOT corrected for the 185. On MDI, you may have, hence "stacking" the insulin. Correcting twice. Does that help?

    As far as dosing goes, you mentioned he is now on Lantus and Novolog? You should have a sliding scale with correction factors to help you dose. When Ella was on MDI her's a straight 1:24. So, for every 24 carbs she ate, she received one unit. We dosed after she ate. Now, with a pump, we pre dose 50-100%, giving the insulin some time to start working to (attempt to :rolleyes:)avoid those post-eating spikes. So, I had made a chart the wrote out her BG ranges and how much to get to correct for that and then her correction factor in a different chart with breakdown for every 12 carbs (.5 unit). Then, you added them together to get the total dose.

    ~Jenn
     
  3. Hayden'sMom

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    thank you....

    soo... if you give a correction when there is already insulin in the body.. does this mean that we should give him less and still do a correction -or- let him ride high for the snack and deal with it at meal time???

    thanks... some days this all seems so clear to me.. today i feel completely clueless!!!
     
  4. mommylovestosing

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    It depends on how long it's been. If it's been over 3 hours then I would do some sort of correction if he's still high...
     
  5. Amy C.

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    Always give insulin for the food, be it a meal or a snack. To avoid stacking means to wait 3-4 hours in-between corrections. If he wants a snack within that 3-4 hours, give insulin just for the snack.
     
  6. angiej

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    I wasn't sure from your post whether you were confident with carb counting, or whether you were fine with it but struggling to match the insulin to the carbs.

    If you would like some support in learning to carb count, I would like to recommend you to this site;

    http://www.bdec-e-learning.com/

    It is a free resource and what I used to start to learn to carb count 5 or 6 years ago. It has been written in the UK, but I see no reason why it would not be of support to you.
     
  7. Hayden'sMom

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    THANK YOU THANK YOU THANK YOU:p
     

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