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Newly diagnosed questions

Discussion in 'Parents of College Kids and Young Adults with Type' started by Tarheel84, Sep 18, 2007.

  1. Tarheel84

    Tarheel84 Approved members

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    Sep 3, 2007
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    My son Chris was diagnosed this summer..honeymooning with Lantus (10 units) since August. He called me last night and mentioned that he has had a couple of high readings (one at 250 and one at 300). The one at 300 was at 9:30 at night after dinner at 7:30 and before his Lantus shot at 10:00pm. The next day his readings were 120 and 109. Do you think this is due to the Lantus wearing off?

    His Dr. now wants him to take 3 units of Humalog only at dinner meal until they can evaluate his numbers from earlier in the day. I thought Humalog was supposed to be matched with the amount of carbs that were consumed.
    He has never had a low so far since he has been on such a low dose of Lantus. (this is what I am most worried about)

    He is 2 hours away at college and this is making me so freaked out. I was hoping that any changes in his insulin could have been made at Christmas when he is home for a month.

    The CDE just emailed me and asked for his pharmacy # and said to take the 3 units at dinner...no other instructions. I emailed her back with a few questions.

    Does this all sound normal and am I just getting too worked up? I am a worrier and I feel like I don't know so much....and my son knows even less.

    How long does it take to get the hang of taking insulin?? From experience...what are the top 5 things (or more) that my son needs to know?? Since he is not one to go to message boards what is the best way to learn everything he needs to know?

    Linda
     
  2. Hollyb

    Hollyb Approved members

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    Hi Linda,

    First, welcome and while there is no great time to get a dx of diabetes just before going off to college is really tough. I totally get how worried you must be.

    The good part is that at this age, your son will soon know more than you (and more than most doctors) about managing diabetes. My son was dx'd at 13 and it was amazing to me how quickly he "got it."

    The Lantus could be tailing off a little before the full 24 hours is up, or your son may just be starting to need some insulin with his meals and since dinner is usually the biggest, maybe showing it most there. Either way, this is a normal progression and his dosage adjustments will have to follow the progress of his honeymoon rather the calendar. Don't worry when his needs go up quite dramatically -- young men typically eat a lot and need a lot of insulin (my 15 year old, 2 years after diagnosis, is taking about 65 units a day and rising).

    Is your son a reader? There are a couple of really good books that would help him get a grip on things. "Using Insulin" by John Walsh is sort of the bible but it can be a little overwhelming. I think "Think Like a Pancreas" is more readable, less technical and better for beginners (though really good for anybody). It will really help him start to understand what he is trying to do with the insulin, and when the time comes for him to count carbs and adjust his own dosage, he'll be prepared and confident.

    Meanwhile, the thing to remember with a fixed dose is he needs to try to eat about the same amount of carbs each dinnertime -- that will help evaluate whether the dose is appropriate, and then match his food to his insulin. So if he has one serving of rice or potatoes or whatever most nights, he shouldn't suddenly double that unless he's going to subtract it somewhere else -- like water instead of milk and no dessert. Hopefully you guys have at least been taught "exchanges" so he'll be able to guesstimate his meals fairly confidently.

    Eventually the goal will be to reverse that, and match his insulin to his food. Once he learns to count carbs, he'll have much more freedom and be able to eat more or less when and what he wants (though "grazing" will still be problematic).

    Good luck. It must be really hard having him far away at a time like this, but he'll get the hang of it.
     
  3. susanH

    susanH Approved members

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    linda,

    i think holly has some great suggestions, although i can not speak to dosing with lantus (my son has a pump) i do know that they seem to master the carb counting faster than you'd imagine. i spoke to the dietician at his school and she was very glad to provide carb counts on most, if not all, of their menu items during his freshman year. he had some "adjustment" time, mostly increasing his basal rates of delivery cuz that college food is just so starchy and he wasn't estimating correctly until he saw the actual counts in their menu stuff...he was underguessing alot.

    is there a dietician on campus that could give him some carb numbers? with everything else that's variable, maybe the carbo counts would help just a bit.

    i'm sorry you're dealing with college and a new diagnosis at the same time. OSUMom's son was diagnosed a few weeks before he left for school. She's been there too!
     
  4. BrendaK

    BrendaK Neonatal Diabetes Registry

    Joined:
    Oct 29, 2005
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    I'm in a similar situation as your son. I'm recently diagnosed and honeymooning on 9 units/lantus a day. I just recently talked to my endo about when is the right time to start Humalog and he said that when my 2 hour postprandial numbers are consistantly 180 or over after meals then we'll add fast acting. The key is it has to be consistant!! I would really question what the doctor says -- yes, you do use fast acting according to the number of carbs you have, not just a flat 3 units at meals.
     
  5. Isabelle's Mom

    Isabelle's Mom Approved members

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    Hi Linda,
    Welcome to the forum - sorry about your son's diagnosis. You've found a great place here on the forum, though - these people are wonderful.
    As for books, if you haven't got one already, get a "The Calorie King Calorie, Fat & Carbohydrate Counter". It will help a lot with the carb counting, and even has loads of information on restaurant foods. Our CDE gave us a few of these, so we didn't even have to buy them.
    The books that Holly recommended are my favorites. I would start with "Think Like a Pancreas", by Gary Scheiner, first. Like she said, it's very readable.
     
  6. Margaret O

    Margaret O Approved members

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    Hi Linda,

    So sorry your son was diagnosed right before college. It is hard sending our kids off and I know you are worried... it comes with the territory.

    Encourage your son to continue to check in with the endo (or diabetes clinic) every day. We did that when our son was d'xd at 13 and they let us call until we were comfortable going solo; well past the honeymoon stage. Its like a safety net that you know is there, even if the numbers are in range. The people the specialize in Diabetes management are saints IMHO. They seem to have more patience than I can even imagine. My guess is your son is "getting it" quicker than most because he has to.

    We encourage our son to always have glucose tabs, or gel, or whatever he uses for lows, in his pocket or backpack. Cargo pants are great for all the things he carries. Although I wonder if there are a lot of glucose tabs rolling around in the dorm washing machine now. :rolleyes:

    We use to tell ourselves to "take one day at at time". I would worry about everything and drive myself crazy, so I would need to ground myself sometimes and try to just get through the next meal or the next activity. It soon becomes routine. :cwds:

    Margaret O
    Mom to DS Pat-18, dx'd 4/16/03 T1
    DH- Bill
    DD -Cate-15, non D
    DD-Liz-8, non D
     
  7. OSUMom

    OSUMom Approved members

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    Linda,
    I've been waiting to think of how to post here. My son very quickly was put on an insulin pump - 3 weeks from diagnosis. I don't think he was honeymooning for very long as I think he had a late onset of his diabetes if that is the right terminology. (?) His blood sugar was over 1,000 at diagnosis. We had many appointments with 2 CDEs - one visit with the nutritionist CDE and then a few with the pump CDE and of course the endocrinologist. This was all in addition to the few hour class we had before our son was released from the hospital. Do you and your son feel free to email and/or call your CDE and/or endo whenever you have a question as you continue to learn? You can use the search function on this board which is great. It is on the blue band up above. I bought Think Like a Pancreas book. My husband and my son are the insulin/ratio/pump/numbers guru people in our family. I will ask my husband tomorrow what key things he has to offer as help for you all.

    Check out the other forums also. There may be slight differences based on having an older child/college age, but the parents of the younger kids are a wealth of information. They run circles around me with knowing so much more than I know. Reading through the threads would provide a great information plus other places on this Web site have great info.

    Here's basic info from JDRF. You can click on specific words for further info.
    http://kids.jdrf.org/index.cfm?fuseaction=home.viewPage&page_id=18840E84-5004-D739-A586F7C44557BDEA

    My heart just goes out to you completely because you are far away from your son!!! :cwds: Keep communicating with him and with us!! {{hugs}}
     
  8. PattyR

    PattyR Approved members

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    Sep 2, 2007
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    Welcome to the boards. It is very tough when they are newly dx and you can't be there. My DD was diagnosed while away at her 2nd year of college :eek:. I agree totally with the books the others have mentioned. Encourage him to visit the college dietician as someone else mentioned. My daughter received much useful information from her with regard to carbs and meals.

    Hang in there. By the time he returns home for Thanksgiving and Christmas you will be amazed at how well-adjusted (D-wise) he has become.
     

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