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I think we're getting somewhere

Discussion in 'Parents of Children with Type 1' started by HelenaHandBasket, Jun 26, 2011.

  1. danismom79

    danismom79 Approved members

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    This is my thought as well. Once they make the full transition to daytime Lantus, hopefully it will be easier to gauge what his needs are.

    To the OP, another possibility is to keep the Lantus as a split dose - 2 shots. Just throwing it out there, not trying to contradict your endo.
     
  2. wilf

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    It's a way to go, but my sense is that this lad is setting up for a good honeymoon and if that's the case then no need to worry about splitting Lantus until that starts to fade..

    Pretty important to measure about now - he has 2 units on board. :eek:
     
  3. HelenaHandBasket

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    I agree. If only because he seems to be reacting to the Lantus like it's a 12 hour thing instead of a 24 hour thing. His body hasn't gotten the hint or something. ;)

    I'm about to recheck. Be back in a coupla.
     
  4. HelenaHandBasket

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    WTH?! The mystery deepens!

    201!!! :eek:

    I'm stymied. :confused:
     
  5. emm142

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    I would put money on his basal being too low. 30 minutes just isn't time to drop from 147 to a rebound level number and rebound all the way back up to 200...
     
  6. wilf

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    There will be different theories.. ;)

    The numbers since supper (like lunch) could be due to:
    1) slow digestion of lunch;
    2) not enough Lantus;
    3) moderate low followed by modest rebound.

    I think you'll again find subscribers to each possibility - my bet is STILL on 3 and I still would be very happy to be proven wrong.

    The way to prove me wrong is to do this at breakfast tomorrow, and to give him the snack at the 1.5 hour mark if he's at or below the pre-meal BG - rather than waiting and measuring.
     
  7. danismom79

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    I think he just needs more basal. The boluses get him down some, but they can only make up for inadequate basal for so long.

    Just to give you some perspective, it took my daughter at least 2 weeks to get out of the high-200s and 300s. It's a process, and you'll see numbers you don't particularly like. (sn: I can't remember if you said he's on syringes or pens for Lantus, but with syringes, you can dose in half units.)
     
  8. wilf

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    Actually it is..

    If we use the 1800 Rule to figure out the effect of his insulin, then we get the following:
    - I'm assuming TDD is around 15 units;
    - 1800/15=120, so 1 unit could drop him about 120 points

    A half hour ago he had about 2 units on board (assuming he responds to Novolog like my DD and others), with the potential of dropping him around 240 points over the following 90 minutes or so and with that drop fastest in the first part of that period.

    Question to the OP - starting with yesterday's supper, how much insulin has he gotten in total over the past 24 hours (not including the supper bolus)?
     
    Last edited: Jun 28, 2011
  9. HelenaHandBasket

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    And this is the end of the day when he had 2u of Lantus this morning. I'm thinking it either isn't enough or it just doesn't "hang" with him long enough.

    He's on Pen for Novolog and syringes for the Lantus. He started with half doses.

    I'm not stressing too much because he's still low enough below 300 that I can breathe a little. Just not crazy about the dramatic dips and rises in such a short time and what it all means. I'm starting to get irritated. Not in a terrible way, but in "mama bear has to figure this sh*t out!" kind of way. :mad:
     
  10. danismom79

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    But he'll also be getting 3u of Lantus in the morning.
     
  11. HelenaHandBasket

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    Not including which supper bolus? Last night's or tonights?
     
  12. wilf

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    You expecting it to peak in 90-120 minutes?
     
  13. wilf

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    Tonight's.. :cwds:
     
  14. emm142

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    Sure, he had 2U on board, but he also had a load of food digesting. 1.5 hours after eating I often have 4U on board, which should, according to my ISF, drop me 400 points... That doesn't mean I have to have a snack every time I'm below 500 at the 1.5 hour mark..

    You just can't look at IOB for food in the same way as you would look at IOB from a correction.
     
  15. danismom79

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    Yup, and you're already learning how to analyze, and where adjustments might be needed. After 3 years, we still have days where my daughter's range was somewhere in the 50s to somewhere in the 300s. It just happens sometimes. In my experience, there is almost always a reasonable explanation - whether I can figure it out or not is another story. But yes, it is extremely frustrating.
     
  16. HelenaHandBasket

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    16.5

    5u at dinner last night
    2u of Lantus at 9p
    2u of Lantus this morning
    4.5u of Novolog this morning
    3u at lunch
     
  17. wilf

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    No you can't, but I'm sure seeing the potential for a stiff drop at the 1.5 hour mark. But you bring up a good point - it would be interesting to know what was for supper, and when exactly relative to the commencement of the meal he got his bolus.
     
  18. wilf

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    Thank you. :)

    1800/16.5 = 109, so there's the potential (assuming digestion was done) for him to drop around 110 points per unit, so 220 in total..
     
  19. danismom79

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    I'm expecting it to act like a full unit more than this morning, while his boluses and corrections presumably stay the same, so tomorrow she may have a whole different situation. I wouldn't compare today to tomorrow in terms of possible lows/rebounds.

    In other words, she can't necessarily "prove you wrong" (or right??) since he's not getting the same doses.
     
  20. Heather(CA)

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    That's why I said "Keep an eye on it"
     

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