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Need help with crazy numbers

Discussion in 'Parents of Children with Type 1' started by Mom2Boys, Jun 25, 2008.

  1. Mom2Boys

    Mom2Boys Approved members

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    Okay so Luke was going low a lot during the night on .5 unit of Lantus so his doctor cut it out completely. At first we were having great numbers, but lately not so much. We decreased his carb ratios, but it's really hit or miss as to whether it helps or not. Any help would be much appreciated! Do we keep decreasing his carb ratios or add the Lantus back in or do nothing? Here are his numbers for the past few days (he's using diluted insulin so I converted it all to as if he were using full strength):
    06/22
    Breakfast:
    8:36AM---96---.5 units
    11:15AM---83---gave one glucose tab (4g carbs)
    Lunch:
    12:31PM---133---.25 units
    3:15PM---213 (after nap)
    4:30PM---87
    Dinner:
    6:02PM---84---.125 units
    7:48PM---200
    8:55PM---164
    10:47PM---124

    06/23
    Breakfast:
    8:19AM---78---.375 units
    10:00AM---323
    Lunch:
    11:37AM---174---.25 units
    1:14PM---120
    3:337PM---145 (after nap)
    Dinner:
    5:20PM---75---.125 units
    8:00PM---236
    11:30PM---230
    2:25AM---163

    06/24
    Breakfast:
    7:58AM---99---.5 units
    10:36AM---173
    Lunch:
    11:20AM---147---.25 units
    2:22PM---242 (after nap)
    4:30PM---196
    Dinner:
    6:18PM---109---.25 units
    8:51PM---164
    11:37PM---223
    6:57AM---116

    06/25
    Breakfast:
    8:55AM---103---.5 units
    10:55AM---299
     
  2. 3js

    3js Approved members

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    I can`t help you out with numbers- my son is waaayyyy older than yours. But I wanted to bump this up for you- hopefully someone with a little one will come along with good advice. Hope todays numbers are better:)
     
  3. twodoor2

    twodoor2 Approved members

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    How old is he and how much does he weigh, and judging from his picture, a toddler or preschooler??? I actually think those numbers are pretty good, he's getting into range by the next meal, and I do see some spikes, but it's hard to prebolus with such young children. Prebolusing would probably help eliminate some of those after-breakfast spikes. I don't consider numbers in the 70's & 80's to be hypo, that's actually normal range. I consider hypo anything below 60 (some people think it's anything below 70).
     
  4. Twinklet

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    I agree with Marsha, for a 2-year-old those look like great numbers! I don't think I'd be adding in the Lantus yet. You'd most likely be fighting nighttime lows again. His wake-up numbers are pretty good.

    You might want to talk to the Endo about lowering his dinner ICR, but I think it's fine left where it is for now.
     
  5. Heather(CA)

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    I agree with Marsha, those numbers with a couple of exceptions are pretty darn good. I would DEFINATELY not add the Lantus back in. Is it possable that the couple of high numbers were just hard to count carbs? I noticed a couple of tests that were possably done before the insulin was finished working. Don't count those, just look at the next meal. Your doing a LOT better than you think.:D I don't see any concrete changes at this time:cwds: Remember, some highs are lows are just part of it:cwds:
     
  6. Tori's Mom

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    I'm just going to echo the others. Your wake up numbers are great-I would not re-start the Lantus either. I would be most pleased with those numbers!! Good job Mom.
     
  7. saxmaniac

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    As the others say, those are good numbers, I wouldn't change a thing. Prebolus more if you want to hit that spike.

    I know it's disconcerting to see him drop overnight, I remember being freaked out by it too. When you're in the honeymoon the pancreas is still doing its job to drive the bg to around 70. That's what it's supposed to be doing.

    You'll know the basal is off when the pancreas is overwhelmed by the basal needs. He'll just be high all the time, and keep going up up up!
     
  8. jendean

    jendean Approved members

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    I concurr. Those are good numbers- remember, you cant expect non-d numbers.
    But when it IS time to restart Lantus, or time to restart a long acting, taking it in the morning instead of before bed might be a good way to go. May eliminate the peak.
    Also they make some bars you are supposed to eat at night to keep your sugars from dipping too much.

    :cwds:
     
  9. Gwyn

    Gwyn Approved members

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    We also dropped out the Lantus when DD was honeymooning. We were advised not to add Lantus back until waking numbers were consistently over 150.

    The numbers you posted actually look amazing for a small child!!!! But if you're worried about the 200s, I would take a very close look at what he is eating and count very carefully. When there is no Lantus on board, every single carb can make a big difference, so using a scale can make a BIG difference. And of course it helps to have a good ratio too!

    Also, try to cut out excess fat if you can. It will raise blood sugars 3-4 hours after a meal and your bolus insulin will be long gone by then. The same can be true for too much protein, although this is less of a problem in my experience.

    Keep up the good work!!!!!
     
  10. Gwyn

    Gwyn Approved members

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    So true--that's one of the things I wish someone had told me when we were first dxed.
     
  11. Mom2Boys

    Mom2Boys Approved members

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    Luke is 28 months and weighs 31 pounds. He was taking Lantus in the morning and still having lows overnight. I don't consider any of the numbers that I listed as hypo since I know that overnight it's his own insulin working. It was before cutting out the insulin that we were having a lot of overnight hypos.

    I have been prebolusing for meals since he is a fairly reliable eater and we're still seeing some high spikes after meals. I know his numbers aren't terrible, but I'd like to get rid of those high 200s and 300s after meals if I can.

    Do you think our insulin could be going bad? Does diluted insulin last as long as regular insulin or does it lose is potency sooner? Our CDE does not believe that insulin goes bad at all and says that we can use a bottle of insulin until it's gone if we want (that would be probably many months if we actually did that). This bottle of insulin was open/made on 05/24. I guess we'll find out when we pick up our new bottle at the pharmacy on Friday.
     
  12. twodoor2

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    If he's getting into range at the next meal, I doubt the insulin is bad. Some children just spike because of high GI food, not prebolusing enough time in advance, or miscounted carbs.

    There's also a lot more leeway with smaller children than there is with adults in regards to spikes. After breakfast spikes are a very common issue with many diabetics since insulin resistance usually is very high in the morning. Also most breakfast foods are high GI (cold cereals, pancakes, waffles) which adds to the problem. Try to give some lowfat animal protein at breakfast, and that also helps to cut down those spikes.

    Toddlers and small children have a higher tolerance for spikes than older kids and adults. If the spike is 220 or less, than that's optimal.
     
    Last edited: Jun 25, 2008

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