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OMG, we're stuck high!

Discussion in 'Parents of Children with Type 1' started by danismom79, Oct 12, 2009.

  1. danismom79

    danismom79 Approved members

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    I've read about it a million times, but any tips & tricks other than what I already know never really sank in because a basal increase always solved the problem before. Starting yesterday after lunch, we've been stuck high - I'm talking high 200s to low 400s!!! :eek: At first, I thought I was just way off on the carbs (ate at Brigham's), but it can't still be that. Then I thought, maybe we're having an honest-to-goodness rebound. Whatever the reason, I can't get her down!

    Boluses are going through, corrections aren't making a dent. She's gone from 0.75u/hr to 0.90 in this time, and I threw in a couple of temp basals for good measure (so far, +25%; going for +30% in a minute). I actually skipped a couple of corrections and tried to get the temp basal to bring her down. We did a pod change last night, so that's not it. No ketones. This is insane.
     
  2. wilf

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    Do corrections by injection, to make sure it's not a pump/site issue..
     
  3. danismom79

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    The insulin is going through because after a meal, she's about where she was before. She's just not coming down into range like she should. She has a new pod, different spot on the body (actually same spot, but turned in the opposite direction, so new site). I'm thinking this is some kind of hormone surge. She just got a huge bolus, and has a temp basal going for the next 4 hours, so if she doesn't budge after all of that, I'll go for the syringe. Thanks for reminding me, that totally slipped my mind.
     
  4. Becky Stevens mom

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    Carla i see that Dani is 10 so probably close to puberty. Ive heard from friends that at the beginning its a real rough ride. Could she be coming down with something? I hope you get it figured out
     
  5. danismom79

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    I thought about that too, but I thought it'd be more of a gradual rise. This just slammed her all at once! I think she is pretty close though, she's almost the same age I was when I started.
     
  6. BrokenPancreas

    BrokenPancreas Banned

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    Carla
    Just wanted to say, AACK!!! It's horrible, but you will get her down to range!!!
    Is this the first time since dx, that she's had one of these stubborn highs?
     
  7. danismom79

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    She's gotten stuck before, but not as high and not as long. Growth spurts usually catch us overnight and in the early AM, so maybe this is more of a girly hormone thing. :eek: This is the first time I've been nervous about it because I'm pumping her full of insulin and I don't know if her body will react suddenly and catch us both off guard.
     
  8. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Yuck!

    Often when Carson is stuck high it's because he needs a basal AND a bolus change/increase. Increasing the basal alone won't cut it, I have to lower that I/C ratio by quite a bit. Sometimes going from 1:25 to 1:15 plus a 200% basal increase. Yes, it sounds like a lot, but he needs it -- mostly in those growth spurts. The only way I've figured it out is with the CGMS!
     
  9. danismom79

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    I really want to just sock it to her, but I'm inching up on the basal. I'm honestly scared to send her to school tomorrow after increasing it like that. She has an hour-long bus ride each way. I may have to take her in myself.
     
  10. hawkeyegirl

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    For us, "stuck high" needs a full correction, plus a big temp basal for a relatively short period of time. So maybe +75% for 1 to 1.5 hours, plus the correction. The combination of the two seems to "unstick" him so that the correction can work.

    Good luck! I hate stubborn highs!
     
  11. BrokenPancreas

    BrokenPancreas Banned

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    \\


    Carla.
    Then don't send her. If that's your gut feeling, go with it.

    Wow, that's a long bus ride!
     
  12. danismom79

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    Ugh, this is making me so nervous! I haven't felt like this since dx, seriously. I'll see where we are in another hour or so. At 8pm, she got 8.4u, plus a +30% temp basal (1.15u/hr). Then I guess I'll cancel that temp and really go for it if there isn't a decent change.
     
  13. wilf

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    8.4 units in one correction?!! 1+ units per hour? Something sounds not right here. How heavy is your DD, and what has her TDD been the last while?

    *****
    Rereading thread - was the 8.4 units bolus plus correction, and if so how big was the correction?
     
    Last edited: Oct 12, 2009
  14. danismom79

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    The correction was 5.8u - BG was 412, correction factor is 50, TDD for the past 2 weeks or so has been about 33u (steadily came down from over 40u, almost since she started pumping). She's 70 lbs. Mind you, this all started yesterday afternoon. Right now she's down to 272, so we're headed in the right direction.
     
  15. Becky Stevens mom

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    Im thinking she was very insulin resistant after being high even for a short time. Steven will get so darn insulin resistant i feel like I need to give him an IV of insulin to get through it! Hope things continue to improve
     
  16. wilf

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    Wow, that's a significant amount of insulin for a 70 pound (32 kg) girl. You're braver than me.. :rolleyes:

    DD was stuck high last night at 375, and I brought her down with 2 corrections of 2 units each (2.5 hours apart).

    You'll want to keep measuring until that correction has totally cleared her system. Good luck, glad to see she's at least headed in the right direction. :) Now it's hopefully just a matter of finessing a smooth landing. :cwds:
     
  17. danismom79

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    That's what's making me think it's puberty related. She's a tiny little thing, but she's packed full of muscle. I think my extra bravery comes from knowing I can suspend her if needed since she's pumping. It's about to get a little tricky though because her basal rate went down at 10, so that temp basal is running her at 0.90u/hr right now. I'm going to check in about 20 minutes, and hope she's not on her way back up.

    We've had the 2-correction-high before, but she's really stuck stuck this time. Thankfully she doesn't have ketones.
     
  18. wilf

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    Yep, there are some advantages to the pump for sure. The being able to turn up/down or turn off the basal is probably the biggest one, as I see it.

    On the other hand, the elegant simplicity of injections is more in keeping with the strengths of this country lad..
     
  19. danismom79

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    Well, she was 202 at 1am, and I kept her basal at 1.05 straight through this morning. Didn't do any more corrections after the one at 8pm, just let the basal bring her down. She was 123 at 5:15, so I put her basals back to normal. I hope that was right. I guess we'll see. Thanks everyone!
     
  20. wilf

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    Hey nice job Mom. :)

    Did you get any sleep?! :rolleyes:
     

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