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Not so good day yesterday...

Discussion in 'Parents of Children with Type 1' started by ashadams, Jul 14, 2011.

  1. ashadams

    ashadams Approved members

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    So, I get home yesterday, cook dinner and get ready to test Javeyn's sugar. It seemed like he was really hungry and kind of misreable all at the same time. I tested his sugar and he was at 489! :eek: He has not been that high even at diagnosis of D. I was startled and did not know where to begin. I gave him one unit of clear and tried to prolong his dinner to see if it would go down some. About an hour and a half later I tested him again. By this time he is really hungry! His sugar was at 442. So, I ended up calling his endo for more advice.

    My problem though is that I was trying to figure out what could make it go so high. He ate a pancake w/ sausage corn dog for lunch. This was the first time that he had this. Is it possible for it to make his sugar this high? He was fine for both breakfast and before lunch, but at dinner we had these highs. Then, after speaking with the endo he said to give him one more unit of clear. So, at 9 PM I tested him and he dropped all the way to 95!

    I was just so confused and upset. I figured I could write to someone who understands the frustration and emotions that this involves, especially when it has only been 2 months since D. :confused:

    Ashley
     
  2. virgo39

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    So sorry you went through this, but glad that he came down after the second correction.

    It is shocking/discouraging to see those crazy numbers for no seeming reason. The more obvious ones would be that the carb count was off, he could be coming down with something, etc., but sometimes it just happens, which totally bites.
     
  3. Christopher

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    Pancakes are one of those foods (for Danielle) that are very hard to get right. They almost always make her go high. So you might want to look at how many carbs you counted for the pancakes. A "serving size is sometimes MUCH smaller than the size of what we consider a regular pancake. Also, the sausage corn dog could have slowed the absorption of the food so that the insulin was done working before the food was done acting on his body. That could also account for the high. Did he have syrup with the pancake?

    Just remember, highs happen. Try your best to figure out why it happened, learn from it, and move on. :cwds:
     
  4. lauraqofu

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    I hate those frustrating highs when you just keep thinking "What the heck?" and can't seem to come up with a real answer. Just remember that so many things can cause an "off" number...a mistake in carb counting (sometimes the carb counts on packaging are wrong or we make a mistake because we're so sleep deprived), a growth spurt, an unexpected fat spike from the sausage, the alignment of the planets :rolleyes:...

    Glad he came down with that second correction. I'm a little confused, though...what is "clear"? What insulin regimen is he on?
     
  5. ashadams

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    He is on Humalin and Humalog. I didn't even realize I wrote "clear"! When we were in the hospital that is the way they taught us - by clear and cloudy.
     
  6. ashadams

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    Chris, he did not have any syrup with it. Thanks for your reply! :)
     
  7. lauraqofu

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    Ah, thanks for explaining. I am not really familiar with other long acting insulins. We use Lantus...which is clear just like Humalog...
     
  8. Christopher

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    OK, thanks. I think a "normal" pancake serving size is supposed to be about the size of a CD. I know when I used to make them, they were much bigger. :eek:
     
  9. Becky Stevens mom

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    I remember being very scared the first times that Stevens blood sugar was very high. Almost panicy feeling:( Now I just get irritated and disgusted and try to figure out what happened. Sometimes thats impossible and you have to figure that it may be high tide or the moon might be full that night, meaning that theres no explanation. When you see a real high number like that its a good idea to have your son wash and rinse his hands real good and do a retest to make sure that its really that high. Giving water to drink can also help to get the #s to start on their way down and always test for ketones too especially if hes complaining of a belly ache.

    Things like pancakes have a very high glycemic value, meaning they can cause blood sugars to sky rocket and stay high for quite sometime after and the sausage with its fat content can slow down the digestion of the carbs a bit. Can you do more testing in the afternoon? If so a couple hours after lunch will tell you if hes getting enough insulin for his lunch. Does he get any clear insulin for lunch or just in the morning with his NPH? The NPH should cover lunch but sometimes wears off in the afternoon before suppertime. He may be coming out of the honeymoon period now. If so, youll start seeing some higher numbers and he will need more insulin to keep his blood sugars in range.

    I know its frightening seeing high numbers like that. You did just fine giving him some insulin and calling the endo for further instructions
     
  10. ashadams

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    Thanks Becky. I was panicy feeling! At first I was scared and then after all I could do was cry because I hate seeing my 3 yr old go through this. I wish I could just take it from him! :(

    But anyway, I actually use alcolhol pads on his finger before I test him. Is this usually a good method? I did check his keytones, which was negative, and I was told to give him at least 8 ounces of water every hour. His numbers have been really good for the past two weeks. We had a few lows in the 70-80 range, but no highs. I guess that's why I was so surprised to see such a high number!

    Thanks for your help!
     
    Last edited: Jul 14, 2011
  11. Christopher

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    The thing you would want to watch out for is his skin drying out with repeated use, and also making sure the finger is dry. I just have her wash her hands before every check with soap and water. When she is sleeping I just clean her finger with a wet paper towel and then make sure it is dry before checking.
     
  12. Tracy1918

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    Wow. That would freak me out, too! I think the highest we've seen so far is 373. Sadly, I'm learning that it happens....

    Matthew does not do well with pancakes at all. It's one food that really sends him high.

    I did get the Fiber One pancake mix and he does FANTASTIC with one serving of those...

    And just remember...what comes up, must come down.

    Eventually! : )
     
  13. Becky Stevens mom

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    Ashley, my son Steven was diagnosed at age 3 also. I remember doing alot of crying in those early days and months. I still do it once in awhile but he's got such a great sense of humor at age 10 that he keeps me laughing most of the time:) I know its hard to believe that one day, hopefully soon,youll both feel that the diabetes is a normal part of life. It will be intertwined with your day to day living so much that it wont take as much away from the days adventures or just happy times together.

    We've never used alcohol pads for wiping fingers. I usually just have him wash and rinse real well and then wave his hands around to dry them. Or at night we use a wet wash cloth and then blow on his finger to dry it. He doesnt wake up anymore
     
  14. ashadams

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    Thanks everyone! I am going to try to start washing his hands before I test him. I just thought that with him being 3 yrs old it might be a challenge. It's definitely worth a try.
     
  15. sooz

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    May I ask you if your endo has given you a sliding scale to use for corrections? Now the pump figures it out for us, but we used to refer to a chart when we needed to do a correction. We would refer to the chart to figure out how much Novolog to give for the correction, added to it the amount needed to cover the dinner and given it all at once along with the dinner. You seemed surprised that he went to 95. 95 is a good number, no? What is your ratio for carbs to units of insulin? How much did you count the pancake meal as? I agree pancakes can be tricky..If your endo hasnt given you a correction chart you might ask him for it. You are doing great, those numbers just change for no apparent reason sometimes. Hang in there! It is SOOO exhausting and draining sometimes figuring out all of this stuff and worrying about doing the right thing.
     
  16. lynn

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    I suggest that you buy foam soap if you don't already use it. When Nathan was diagnosed he was two-and-a-half and using foam soap made him able to see that the soap was all over his hands. It also rinses off way easier.
     
  17. GaPeach

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    I have absolutely no experience with a toddler.

    Highs that get "stuck" for us always required some extra insulin to get them back down (0.50 to 1.0 unit usually). The body simply begind to resist the insulin when DD is in a higher range.

    Reasons for unexplain highs are numerous: missed bolus (at meal), missed basal (Lantus), impending illness, growth spurt are the usual ones. But can include: inactivity that day (car trip or too much TV/couch potato), excitement (adrenaline), extreme activity (adrenaline again), or .... other strange reasons simply unexplained.

    You did great calling the endo. They should welcome calls from patients (especially since you are recently dx.)
     
  18. smcnair

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    alcohol swabs

    The diabetic educator I saw while I was pregnant told me not to use hand sanitizers (unless I was sure they didn't contain any alcohol) or alcohol swabs for cleaning my finger as it could affect the results. . .
     
  19. Alex's Dad

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    I have a soon to be 3 year old and yes getting them to wash their hands is a challenge. She was dxd at 16 months old and we use alcohol only if we have a weird test (a number we don't expect), we recheck using an alcohol pad and always make sure the finger is dry, for the most part we don't use anything, only make sure his fingers aren't sticky or use a wet cloth or paper towel, about using baby wipes I'm not sure, I have read it both ways some people say it doesn't affect the reading other do. Good luck you are doing a great job.:cwds:
     
  20. Lisa P.

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    Just a thought that in skimming I didn't see mentioned.

    Toddlers squirm. If you give an injection and they are twisting and flexing muscles, it's awkward, it's possible to kind of "miss" or to get "leakback" where you insert the needle and press the plunger and the insulin gets squeezed out at the injection site and they don't get the full dose.

    Pancakes would be rough, and sausage would be rough, when Selah was three. High carbs and high fat combined in one meal is very hard to give an accurate shot for, and you kind of have to accept that you'll be reacting later. But your description. . . hmmm.

    I'm thinking this scenario -- you gave him his shot with his meal, but the insulin didn't get in. Within a couple hours, he'll surely be going high. You corrected the high he was at properly, but he wasn't done rising yet. If you had given no correction, you might have seen HI on the meter. Since you gave a correction it worked to bring him down but the meal was bringing him up at the same time, so you stayed stable. By the time you gave the second injection, not so much digestion was left so it brought him down better and fast.

    Selah doesn't always get hungry with highs. She'll be high for one of two reasons -- either because she had "too many" carbs (e.g. I bolused for 20 carbs and she ate 40) or because she had "too little" insulin (e.g. I forgot to give her insulin for her lunch bolus). Both situations are corrected with more insulin so they're kind of the same, but in the first case her cells are getting fuel, but the "extra" carbs are still in the bloodstream. In the second, the carbs are all sitting in the blood stream and none of them can get into the cells to fuel them. So if Selah is high and hungry, I tend to think it's not about getting too much food, but about not having the insulin on board that she needs. So that's why I'm thinking the lunch shot might have somehow been a miss.

    In any case, now you have a bunch of information you didn't have before ! Sorry for the high, we were no stranger to 400s when Selah was three. Make sure with numbers that high you check for ketones so you know where you stand. We used to give Selah black olives when she was hungry but couldn't eat because she was high or couldn't have insulin, they are filling but the fat in them never spiked her, and they are low in carbs.

    Hope you have a great night.
     

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