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Newly diagnosed---worried

Discussion in 'Parents of Children with Type 1' started by KHM, Mar 24, 2010.

  1. KHM

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    I think I understand what is being said here by everyone... in the 3 to 4 hour interval after a bolus and its meal, very frequent bg checks could reveal the low we've been missing and which would lend support to the rebound idea. The tricky thing is the content of the meal---not just number of carbs but whether metabolically their glucose hits the blood supply quickly or slowly (entirely another thing to learn).

    It seems from what I read that glucose is released more slowly from meals with relatively similar, and large, proportions of fat and carbs, exceptions being whether or not there are simple sugars included as part of the meal. If this is correct and DD IS in an over-dose/rebound situation, how would it look over time in the bg?
     
  2. sammysmom

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    The thing is, the rebound may not even be happening. It's all just speculation at this point. Testing more often would help you know that for sure (Yeah for the cgm!!!) but it does seem like you are checking often enough. IF it were happening, and you caught it you would see a low bg number followed by a high bg number, the time span between the two is what many people differ on, some say fast, some say longer period of time. Many people just do not understand that bg bounces around a lot with younger children. Rebound is a subject that is highly debated around here. Lots of different opinions on that subject!

    I am so happy that you will be getting a cgm, it really does come in handy, kind of like a second pair of eyes to help you out. Diabetes can be exhausting and so can trying to figure out what exactly to do. One person's opinion is just that, an opinion. Age, honeymoon, other health issues all come into play. What works for one child may never work for another child. My son was diagnosed very young and the rules that worked for other children just did not apply to my child. You seem to be doing a great job of understand the concepts about t1d, better than a lot of people do in the beginning. Good job mom!
     
  3. badshoe

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    There is about a zillion things that effect blood sugar. Chasing them can make a person nuts. (Take Brensdad for example)

    You are still probably working out the whole basal/bolus vocabulary thing let alone getting the balance between them right.

    From the OP way back 130 or so posts ago (we love us some newbies here at CWD don't we?) the issue seemed to be sustained highs. That could indicative of basal being low. I have found that chasing low basals with extra bolus it is real hard to come into range.

    I am consistently amazed with how little a basal correction it takes to make a big difference in our kids goofy numbers when it is low. Also how much bolus it takes and how much of a roller coaster the number are when the basal is low.

    I am a big believer in fix the basal first.
     
  4. frizzyrazzy

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    you've got it figured out pretty well. :)

    over time - you'd see just this - a low with a strait up high following it. and you'd probably see that repeated at every meal OR you'd see a low followed by a high that does not come down with repeated corrections. by the time morning rolls around, bg's are back in range and you see the cycle all over again. The point we'll all saying is that YDMV - your diabetes may vary. :) What I see, what Badshoe sees (through his clown glasses, and what fun that must be ;) ) what anyone sees, may not be what you see. You're going to have to see what you see...and then we can all weigh in again. :)
     
  5. badshoe

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    Oh it was all fun and games and then this: "I do know a thing can be overthought. I'll think about that.. "

    That is just a big kettle of crazy, with a whisk in it.

    I am still struggling to get grip on it. But getting back to Zen fundamentals - It has come to this, If Brensdad makes a new post on a forum and it get no views did it make the sound of one hand clapping?
     
  6. Brensdad

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    I don't know if it's been mentioned, but I didn't see it. Of course, I am nuts. :D

    Try to get at least three nights in a row of unbolused readings if at all possible. During the day, bolusing is everything because, well, it's hard to eat when you're asleep...unless you're Badshoe.

    At night, basal is king, and you'll never get a firm grasp on the proper basal rate if you correct. Our new endo told us to go three full nights without correcting, no matter what, so we could get a really solid understanding of a pure basal number.

    Of course, we're going to correct if we see a super-high number and ketones, but he insisted that we even let a 400 go uncorrected as long as there's no ketones. His point of course was that 3 nights of crappy BG will give you the data you need to avoid highs and lows for many nights to come.

    And this is the Chief of Pediatric Endocrinology at Texas Children's, so for once I'm going to listen to someone other than myself.

    I'd say since you're able to string together coherent sentences this soon after diagnosis is a good sign that you are doing very well.
     
  7. frizzyrazzy

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    You know, we're all just trying to get a grip on it. I think the day any of us think we have it figured out, is a dangerous day.

    besides, we have way too many big kettle of crazy's here. lol So I think we might be safe.

    I keep meaning to ask - is the video of the car vs meter still online? and ...if so do you suggest this still? Ian has all these "when diabetes is cured ..." scenarios (..he'll drop his pump off a cliff, he'll burn all his supplies....) and I'm contemplating doing what you guys did. First I need to review the video...I have so many spare meters here that I think he'd enjoy it.
     
  8. frizzyrazzy

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    "I do know a thing can be overthought. I'll think about that.. "
    and I'm wondering if that should be added to my quote collection...
     
  9. wilf

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    The "glycemic index" is a measure of how quickly glucose from different kinds of carbs will make it to the bloodstream. There is a good intro reference here:
    http://www.diabetes.ca/Files/diabetes_gl_final2_cpg03.pdf

    Notwithstanding others' comments, all I know is that your 44 pound 4 year old daughter is getting as much insulin each day as my 117 pound 13 1/2 year old. Your daughter is getting between about 1.1 and 1.4 insulin units per kg body weight per day, which is a lot more than children would normally need.

    My sense is still that she's getting too much insulin, and is going low and rebounding regularly. What were her numbers like today?
     
  10. frizzyrazzy

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    I don't think anyone is disputing this. She's taking more than Ian - and he's 98lbs.

    I think we all agree, she's taking a LOT of insulin.
     
  11. badshoe

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    My most esteemed colleague the honorable Brensdad makes a number of good points in his fine post. Possibly the most significant his last. You are indeed doing quite well indeed. Consider he himself has been type 1 for nearly a decade and this post may in fact be one of his finer strings of coherent sentences in that time.

    The body of his advice is also quite strong (and I note he appropriately attributes it to the Chief of Pediatric Endocrinology at Texas Children's) that being to be sure you have sound trends over a number of day before correcting.

    (I have personally taken this to heart and keep a fresh Creme Brulee on my bedside table each night for three or more days before correcting the menu to another desert. How he know this I am unaware but I digress)

    I also feel it warranted to observe that the closing sentence of of his first paragraph is also most erudite.

    I closing I must say it is a pleasure to have him come and play.

    Thank you Mrs Brensdad's mom for letting him come outside.
     
  12. badshoe

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    Yes Frizzyrazzy I believe this is the URL you are looking for and I highly recommend it.

    It did wonders for both her and my state of mental health (freebie there Nick.)

    "We have way too many big kettles of crazy's here" - A phrase that here means BadShoe and Brensdad?
     
  13. frizzyrazzy

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    thank you for the link. I will let you know if we try it. ;)

    and no, "big kettle of crazy" it's been in my sig for a long time. I can't even remember why I put it there, but it seemed appropriate at the time. lol. :)
     
  14. badshoe

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    When you do it - Film it.

    And I was shamelessly co-opting your tag - not that I would admit it publicly
     
  15. JJsMomma

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    OK I'm laughing too hard at Badshoe's post to continue!! OP....I hope this all works out quickly for you.....and I've just realized how many scary smart people are on this community! I want to go rock myself to sleep in a dark corner now....
     
  16. KHM

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    I think I've been completely misled: what will be the most difficult thing to learn here is all the subtext between you "Senior" Members. And (eh-hem) did anyone notice I was promoted to "Member" today?

    Should anyone take my "I'll-think-about-overthinking" remark as anything more or less than extreme cleverness in my compromised and vulnerable state then I may stop sharing my bg data, fertile with its promise of inference and implication, with you. And then what will you be doing with your clown glasses and fancy equations?

    I'm too tired. Next bg check in 30 minutes and I need to get this kid to produce a ketone result...
     
  17. KHM

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    I would be extremely flattered. I was rather amused my own self which is comletely immodest and absolutely within character.
     
  18. KHM

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    thanks for the pointer to the glycemic info; I've had that on my "get to it" list for a while. Its important, I know.

    Honestly, today I've been wrung out. She has not been as high today as yesterday but it seems like we've not had much variation---pretty much holding in the mid- to high 200's until just before supper and the evening---now looking at about 300.

    I will post today's numbers in the morning. Its late. Thanks for all your concern and well considered insight. It has a lot of value.
     
  19. frizzyrazzy

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    rofl. don't feel like you're being left out. Badshoes has been doing this for years...with 2 kids. If you ever need an example of the attitude that gives your kids a happy life with diabetes, then talk to their family. There are a lot of silly jokes that fly around. :)

    Oh, do you have a blood ketone meter??

    http://www.abbottdiabetescare.com/content/en_US/20.10.30:30/product/Product_Profile_0004.htm

    most of us use that for ketones rather than what most kids call "pee-tones".
    I don't use that meter for anything other than ketones even though you can get glucose strips. So add that to your list of items for your new endo - an RX for blood ketone strips. :)
     
  20. saxmaniac

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    Ketones will be a good data point here... if you do see ketones, it's a strong clue you just need more basal, despite being on this high of a dose.

    As others said, if the basal isn't close (I hate the term right) then everything else falls apart. I think of the basal as the foundation of the house... if that foundation isn't strong, all the stuff you put on top of it will fall down. (The trick with D, is that foundation keeps changing every few days!)
     

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