Our weekend with Apidra

As you all know, the pump wasn't working too well for us and we knew eventually we'd give mdi another go. We started using apidra this weekend (my hopes to combat the frequent eating of kindergartners) Keep in mind, we already had bad post prandial spikes on humalog so my hopes were just to get her in range quicker because I hated my daughter staying high with humalog. I've kept a very detailed log of her numbers because I want to make sure she won't go low at school. I was curious to see what you all think about them? I'm liking what I see honestly. Any changes you think I should make?

5 30 dinner- bg100- approx 45g carbs- 2 units
6;50- 230
730- 110
8pm-105
8:53pm- 93
9:24pm- 99

breakfast
8am- 151- 10 min pre bolus. .5units for eggs blueberries
9:19- 104
10am- 95
10:35- 89
11am- 83
11:31- 111
12:16pm- 79

Dinner
6:48pm- 85- 2 units ravioli and meatballs, approx 40g c
7:41pm- 249
8:28pm- 134
9:12pm- 80
9:35- 65- tootsie roll : 65 an effect of ravioli

10:06- 94
10:40- 109
11:30- 153
1am- 159
2am-180
4:13am- 118
7am- 187
9:39- 182- breakfast. 1 egg and 1 slice of bread. 1 unit. Prebolused about 10 min
11am- 260
11:42- 231
12:05pm- 178
12:33pm- 109

12:51pm- 87- lunch prebolused 10 min. had rice chicken apples and 3 cookies
1pm- 77
2:23pm- 249
3:30pm- 113
5pm- 87- dinner 1.5 units
6pm- 248
6:55pm-150
140
8:30- 130

i don't ever give bread for breakfast but had to this morning. It seems like with apidra, it doesn't matter if you prebolus or not, you still get the same spike.

 

I hope there are folks who could help you. I don't see a problem.

Those numbers look great for a 4 year old. IMHO, the spikes are not all that high. A spike is up to 300-400, not under 250.

10 minutes is not a whole lot of time for any insulin to start working. In my son, it takes about 20-30 minutes to start lowering the sugar.

Try giving the shot 15-20 minutes before the meal (as long as she is in range) to see if that even things out.

You ought to consider a CGMS so that you don't have to test so much.

 

We were definitely seeing spikes higher on humalog. I couldn't stand it. At least these somewhat high numbers go down quicker.

I'm only testing her like this so I can see very clearly what's going on before sending her to school for them to do it. I didn't want to have her nurse use the apidra before I really knew how it worked for her. Ill probably go to her school this week just to make sure everything is good also. I knew it had that steep drop so I wanted to pinpoint when it would happen. I don't see an issue either, but there are people on here who have had so much more experience with diabetes than I have so I just wanted to get some opinions.

 

Looking good to me. We've been using Apidra for years, because it reduces or eliminates that pesky post-meal spike.

If you want to get that spike down further, consider lower GI foods. :cwds:

 

I dont really know how much lower I can go. What foods would you consider instead? Ive been looking for new ideas but haven't had much luck.

 

An all protein breakfast would be low glycemic. Bacon, sausage, cheese, eggs would not add up to many carbohydrates.

 

Since we're currently not pumping, I need to give her at least 11-12g to even give a half unit, this is one instance when pumping was easier lol

 

Vegetables are low glycemic. Most have carbohydrate. Whole grains are higher glycemic. Oatmeal is a good food for breakfast.

Look for food with fiber -- this slows the digestion and allows the insulin to match the food.

 

Have you considered untethered?

Just slap a site on and hookup to bolus. Of course you would have to fill cannula and make sure no bubbles an tubbing is filled to end before blousing.

 

Also there are plenty of times that we do not bolus even on the pump if there are just a few carbs.

 

The only problem I see is that your testing too soon after insulin after meals (1-1 1/2 hours is too soon)...Throw those numbers out. It takes 2+ hours for Apidra to work

 

Give them what they want within reason. You don't need her resenting D more because of a special diet....

 

I don't get the impression that this would be a normal amount of bg checks for her, just what she did to view the spikes.

Just because you don't test doesn't mean the spikes don't happen.

 

Right, its not. It was our first go with apidra so i wanted to see the times in which it peaks and drops so I'm comfortable knowing how it works.

 

I'd love to know what you guys feed your kids that you find works well with D. My daughter is growing tired of the same thing I feed her everyday for breakfast and lunch. It's healthy for her, I really try my best to have her eat healthy and see spikes as little as possible. She gets grilled chicken, broccoli and brown rice every day for lunch. She's a very good eater so I don't have to worry about her being picky.

I'm thinking low carb wraps with lunch meat would be a great option too. How do you guys normally deduct fiber, if you do at all?

I'm going to try oatmeal for breakfast and see how that goes. I got the high fiber one.

 

we had many issues with pumping and i got fed up. I'm trying my hardest now to make mdi work the best it can for my daughter.

 

She was so excited to get a black and white cookie last night. Even better was that it didn't make her sugar crazy like I thought it would.

 

I don't deduct for fiber anymore. I found it messed us up.

As for spikes, I think there is a balance to be made. It seems like she's already eating a really healthy diet, so some spikes are always going to be normal. Even in people with out diabetes, they spike. It's just a matter of matching the insulin precisely to the food, and a good prebolus does help in that regard.

What I do find with Apidra, and we've been using it for a year now, is that it has a weird tail end. Even if the majority of it's done working at 3 hours, sometimes around 5 hours I see a drop. I also have found it's becoming ridiculously hard to do basals because of it. It's almost like I have to have double the basal periods to compensate for this weird tail. I don't know how else to explain it, but I am finding that we are doing a lot of roller coastering.

I'm not also sure that, for us, it really helps with spikes.

 

As a family we eat reasonably healthy. I personally believe in everything in moderation. Seth's diet did not change after dx'd except that if he drinks soda, it's usually diet. Juice is for lows (He has chosen not to drink soda for the most part) Type 2's watch what they eat, Type 1's count what they eat...At least that's how we do it

 

Thanks, I didn't see that...

I know spikes happen, I just didn't want her to make adjustments based on early tests because those were the only highs I saw