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Okay, somethings wrong here.

Discussion in 'Parents of Children with Type 1' started by CaitlynGrisham, Apr 17, 2012.

  1. CaitlynGrisham

    CaitlynGrisham Approved members

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    I have been having some issues with BG control lately, mostly because I don't have my CGM. I can't get another transmitter for at least a month (long story), and I am kind of flying blind until that time.

    I have noticed that my basals have been steadily increasing over time since my diagnosis. I assume that this, in general, is relatively normal (certainly not unheard of). However, my basal rates are really starting to make me wonder if I am doing something wrong.

    My current rates are:

    12AM - 1.0 u/ hr
    4AM - 1.5 u/ hr
    8AM - 3.8 u/ hr
    12PM - 3.750 u / hr
    3PM - 3.85 u / hr
    6PM - 3.2 u / hr
    9PM - 3.1 u / hr

    Total basal: 66.9 units!

    This seems to be a lot of insulin to me! I am slightly overweight (5'7'' and 190lbs), but I don't know if that could be a problem here. I have eliminated a site problem, because I've tried just about everywhere on my body and the basal that I need never changes.

    It's really strange because, a few days ago, I was still on lantus after going into the hospital for various things. I switched to MDI to offer myself a pump break and to make it easier on the hospital staff while they fixed me up. Anyway, I was only on 42 units of lantus! My BGs were still in range; in fact, they were lower than usual!

    I've talked to my endo, and she is just as confused as I am.
    Is there something that I am not seeing?
     
  2. Christopher

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    I have always taken the approach that a person's insulin needs are their insulin needs are their insulin needs.

    I guess for me the more important issue is, what are your bg's like? Are you seeing a lot more highs so you are raising your basal? If so, are you sure it is a basal issue and not a bolus one?

    If your average bg is in range or where you want it to be overall, does it really matter how much insulin it takes to get there?

    TDD really is dependent on so many factors, age being a big one. My daughter was dx at 8 and is now 13 and I have seen her TDD increase steadily.
     
  3. CaitlynGrisham

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    That's the impression that I was under, too. At least, I was until my endo called me on the basal rates. She said that she'd never seen anything like my rates and that they weren't normal.

    My BGs are still slightly high. On my meter, my average is 180. ): Yeah, my blood sugars have been inching up, so I've been raising my basal. I suppose it would make sense that I could be mistaking it for a basal issue if my carb rations or ISF are off...hmm. I didn't think of that.
     
  4. Christopher

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    I guess I would have an issue with my endo if they said something like that. What is a "normal" basal rate for an 18 year old female? How did your endo determine that? Whenever I hear the word Normal being used in context with diabetes it raises my fur a little bit. Diabetes is SUCH an individualistic disease and there are SO many factors at play, who is to say what is "normal"? What works for my 13 year old female may be completely different from someone else's 13 year old female. Which one is "normal"?

    So I guess I would expect the endo to help you more with problem solving and less with judging what is normal or not.

    Just my 2 cents.
     
  5. CaitlynGrisham

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    Yeah, I was definitely a little taken aback. I also hate the world "control" when it comes to diabetes.
    I am thinking about going to consult the other endo at the clinic that I go to. I've seen her a few times when my original endo was out of the office, and I like her quite a lot. Maybe she'll be able to ease my mind a little bit about the whole basal situation.
     
  6. Christopher

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    Nothing wrong with getting a second opinion, especially when it has to do with your health. Go for it and good luck!
     
  7. CaitlynGrisham

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    Thank you so much! :3
     
  8. Tyggirl

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    Hormones can play a number on those numbers too. Like crazy mess with them. I know when I was 15-18 I needed around 85+ units a day of NPH (taken twice a day), pluse 50+ units of R. (I'm old btw so this was before Humalog/Novolog/Apidra and Lantus were out). It crept up in my teens and then dropped like a rock in my early/mid twenties. So having high basal rates isn't unlikely.

    The large difference in Lantus/Basal is a little odd. But since you were in the hospital you may not have been experiencing the typical stresses of your everyday life that may cause you to need more basal. If you are running a bit higher then you may be needing more insulin too. I know that I often have to be aggressive when I've been running on the higher side until I come down and stay down for a while.

    Good luck figuring it out!
     
  9. sooz

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    Perhaps you should take a look at your carb ratios. What are they? Are they also different depending on the time of day?
     
  10. CaitlynGrisham

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    My carb ratios are as follows:
    12 AM - 1:5
    6 AM - 1:8
    8 PM - 1:10

    And my correction ratio is 1:25 mg/dl with the insulin lasting 3 hours in my system.
     
  11. Lenoremm

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    Maybe consider looking at your total daily dose relative to your basal. From what I have seen some people do well with a 50% basal 50% bolus to make up there TDD. DS is currently on more of a 40 % basal, 60% bolus=tdd.
    I am not sure if this will help you but it may be worth looking at. Good Luck.
     
  12. emm142

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    It seems like a lot to me. Do you have many lows? A mixture of bad lows and bad highs could indicate that you are going low and rebounding.
     
  13. KRenee

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    Although I agree with the idea that everyone needs the insulin they need, my dd and I have discovered that insulin resistance is very real. My dd decided to eat very low carb for a little while and her basal rates dropped dramatically...and when she resumed eating a normal diet they rose only a little.

    If it were me, I would do two experiments. 1) eat very low carb for a day or two to test basals and make sure you aren't dropping low and rebounding. Then 2) I would eat low carb for a few weeks to see if you get a change in basal. If you are resistant, it seems that you can reset it to some degree.

    After considerable research, I am convinced that it is a healthy way to eat, but not everyone agrees.
     
  14. CaitlynGrisham

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    My TDD is usually between 95-115 units, depending on the day and whether my family eats a starchy dinner or not. That means that my basal is taking up a significant amount of my TDD :eek:
     
  15. CaitlynGrisham

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    I don't have very many lows (at least, that I'm catching!), but I have noticed a lot of very bad highs. I seem to be swinging back and forth, while I very rarely find myself in the middle :(
    It's really making me frustrated, because I am trying my hardest to sort through all of the numbers and make sense of them...
     
  16. CaitlynGrisham

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    Thank you for your imput! I will definitely try this. I think I will go low-carb tomorrow to get a snapshot of what my basals are really doing. I am going down to L.A. over the weekend, so that kind of complicates things, but I'll work with what I've got.

    That's awesome that her basals stayed low! Hopefully, I can get mine to do that too.
     
  17. ecs1516

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    Check your cartridge the next time you take it out. We found some cartridges (Animas though) that were leaking. Same symptoms as you. You could tap the end of the cartridge after it had been in the pump and a pool of insulin came out the bottom. I guess we were the first one to call Animas about this and they said they never heard of it. Very soon after they issued a large recall on their cartridges.
     
  18. CaitlynGrisham

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    Oh, wow :eek:
    I will definitely check out my cartridge! I am due for a site/cartridge change in the next day or so. That is scary :eek:
     
  19. TheLegoRef

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    The 40/60 is what our endo has said to us as well.

    I know you said you had done MDI in the hospital, but have you tried again since then? When my son's numbers get higher than normal for a while, and changes don't seem to help as much, we do syringes for a few boluses in a row, and see if that changes. If it drops, we know it's something to do with the pump!
     
  20. CaitlynGrisham

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    I just did this this morning actually! The boluses through syringes worked just fine, and my BG is lower than usual. I am wondering if there isn't something wrong with the pump itself...
    I do have a rather large crack across my screen, but I haven't had any noticeable problems up until this point.
     

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