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Huge spike followed by crash -- what to adjust?

Discussion in 'Parents of Children with Type 1' started by Snowflake, Jun 3, 2016.

  1. Snowflake

    Snowflake Approved members

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    I can't figure this out, maybe because my sleep-deprived brain is addled: For the last three nights, my daughter's dinner-time number at 6 p.m. has looked pretty good, like 130. Then she goes high (275-300) around 7:45 or 8 p.m. We haven't been correcting these, assuming a post-meal spike. Then she crashes hard around bedtime, which is about 8:45-9, falling to the mid-50s. Her Dexcom traces look like a steep inverted v.

    Dinners have been relatively high carb but not otherwise unusual. I'm chasing my tail about what to adjust and which problem to tackle first. Any brilliant insights?
     
  2. forHisglory

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    What if you try decreasing I:C ratio and also prebolusing? Maybe feed a no carb dinner or low carb dinner to get an idea of her basal needs around that time? If crashing 3-4 hours out though (and the crash is that hard) my bets are on the I:C. Stopping the spike would be more prebolus time but dinner is such a hard meal. It's usually the most varied and hectic around here.
     
  3. sszyszkiewicz

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    Do an 80% temp basal from like 6:00PM to 8:00 PM and see how it goes.

    Also, has she been running around alot/swimming/sports with the nice weather?
     
  4. Snowflake

    Snowflake Approved members

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    Thanks for both of these suggestions!

    And, yes, now that you mention it, she has been active at different times now that school's out, with more after-dinner play. That might be a factor here also.
     
  5. quiltinmom

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    This sounds plausible. Don't worry though...my sleep deprived brain has missed things like this too. :)

    Trying a low carb dinner is also a good idea. Depending on how normal the spike is for her, she may need more dinner insulin, although it seems counteracted but the exercise (assuming that's what Is causing the lows). So don't change it just yet, but keep an eye on it. And maybe have a bedtime snack prepared too.
     

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