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Rise in BG with heat? & annoyed with something endo said

Discussion in 'Parents of Children with Type 1' started by missmakaliasmomma, Sep 12, 2013.

  1. missmakaliasmomma

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    Does anyone experience a rise in their children's BG when it's pretty freakin hot outside? I ask because the first 2 days of kindergarten, my daughters numbers were pretty ok. Wednesday and today were miserable because of the heat and she ran high both days. Could just be a coincidence of course.

    The second thing is, I emailed my daughters endo with some concerns I had with her starting school regarding her BG numbers and with eating more often (insulin is not done working before she eats again). She has breakfast at 8, lunch at 11, and snack 2-3 hours after. She told me that my daughter shouldn't be tested before lunch and snack and to just cover carbs. No way would I ever do that because day to day, insulin acts different. She could be 200 one day but 70 the next with the exact same regimen. Say she's 200 and just gets bolused for carbs- she's just going to stay high. This is the first time I'm really questioning her judgement. Would that advice work for you or would you still test? I told my daughter's nurse about it today and she said there's no way SHE would feel comfortable just bolusing for carbs either. I'm not going to stop having her checked of course because I don't feel comfortable with that, I just thought that was kind of.. a dumb thing to say.
     
  2. Lee

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    Since she has the Ping, then I would test. If on MDI, unless you are like Marsha and have a spreadsheet that tracks IOB, you won't know if the bloodsugar being 200 is from carbs that are still processing or from an ineffectual bolus.

    That is probably the reason she says to not test, but you have to do what is best for your child.
     
  3. missmakaliasmomma

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    Say you are doing MDI and have a BG of 400 though before snack time and don't test. You obviously would need some sort of correction, something went wrong somewhere. If bolused for only carbs, you'd still be 400 after. This is why it's important to me. Anything could go wrong somewhere. Plus, I want to see how her food is breaking down and I'm trying to find different foods to prevent bad spikes because I don't want her feeling crappy.
     
  4. ksartain

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    We're in a similar situation. Breakfast is at 7, snack at 9:30, lunch at 11:30. There is not enough time between the three to let the insulin finish working. We send in 0 carb snacks so we don't raise his bg even more if it's high. We do still check before snack and lunch and we do correction at lunch, but not at snack.
     
  5. nebby3

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    We have definitely seen heat related highs.

    My dd is on MDI (again) but I still think in terms of insulin on board. It would make a difference in what I do if she is 70, 200 or more before eating so I would definitely check.
     
  6. missmakaliasmomma

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    It's pretty annoying because it is completely different from how things are done at home. I'm sure after this year it will be a piece of cake but for now, its making me crazy. We're trying apidra this weekend to see if that reacts faster in her body than humalog like it's supposed to. If it's good, we'll try it in school too, with the nurse probably testing often to see how it reacts with her in school.

    Anybody with any input on the effect of heat on BGs?
     
  7. missmakaliasmomma

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    I must've been in the middle of my last response because I didn't see your response beforehand. We are planning on going back to MDI also. It might take a couple days though for the nurses to do it since we have to get my daughter's orders changed and everything and different prescriptions in with the pharmacy. When we try out apidra this weekend, we will be doing injections. And I completely agree with you with checking (obviously) I was just very shocked that the dr said she shouldn't be tested. That could potentially have a very bad outcome..
     
  8. hawkeyegirl

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    My son goes low in extreme heat.
     
  9. Dave

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    Test! Test all the time! Test test test!
     
  10. mmgirls

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    I don't think many nurses would feel comfortable dosing for carbs more than an hour past the last bolus without a bg check. At my dd school it would be against the school protocols and no nurse or clinical aide would do so. I would be able to if it did it myself,, but i mostly likely would not
     
  11. suej

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    My DS sometimes goes highish when it is very hot, over 30 degrees centigrade. May have something to do with relative dehydration as he sweats more, and if he does not drink enough water there can be some intravascular depletion of water and thus concentration of the solutes including glucose. So I try to remind him to drink lots when it very hot.
     
  12. missmakaliasmomma

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    Makes sense. My daughter does not drink enough when it's hot out. I've tried eerything but just about shove it down her throat lol
     
  13. Lizzy731

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    The only thing I can comment on is that the same exact thing happened to my daughter last year and now again this year. Her insulin needs at school soar during the 2nd week of school. I need to increase basals and ratios.
     
  14. momtojess

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    I could see where the endo was coming from (kinda) if your child was on MDI. Endo was probably trying to avoid the school nurse staking insulin, but personally I would still want to check even if I did nothing with the #. With the ping I would say there is no reason not to check and treat with an ezcarb bolus accordingly.

    I've read your other posts and concern about your daughter staying high becuase there isn't enough time bewteen eating to come down. My daughter was dxd at 11 months, and there were many many times as a toddler/preschooloer that she would eat constantly. it never really had much impact on her a1c either. Your daughter will be fine. There is a difference between being high with food and iob vs being high with no iob and no reason.
     
  15. missmakaliasmomma

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    Does your daughter continue to need the extra insulin all year round or just in the beginning??
     
  16. missmakaliasmomma

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    Exactly, I still want to know. Like today, she was very high after lunch which doesn't normally happen with the meal she had. If she wasn't checked, she would've stayed high for another couple of hours, not good. I came in and gave her a correction, and she needed it.
     
  17. Lizzy731

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    Just in the beginning..could be combo of heat in the classroom and an upset in her routine from home....but things did change back in a few weeks last year
     
  18. Mimi

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    We always tested at snack & lunch on MDI. Even if we didn't do anything the information was still valuable. I could tell which breakfast foods would cause the biggest spike, helped to determine if ratios were off etc.

    Now we let the pump do the work. ;)

    You might find that just as Apidra acts quicker it is also finished quicker. Frequent testing will help you figure out how long the action time for your dd is.
     
  19. Ali

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    Just as a note. Apidra for me works quicker and is "truly" out of my system in two and a half hours. It has taken me almost two years to rework my mind set from novolog/humolog to Apidra. I love it but when I switched I needed to adjust all my basal settings as well as my ratios and carb ratios and Duration of action time. I love it cause I can dose and eat and for me there is no tail that I have to feed...good luck Ali
     
  20. missmakaliasmomma

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    I'm keeping a detailed log of this weekend to figure that stuff out. Last night at dinner I was shocked at how it worked honestly. She spiked, but dropped to normal 40 minutes later.

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

    At 99, I would normally give extra carbs because of bedtime (which I did) forgetting that we changed her lantus to morning so she didn't need those carbs so I ended up having to do a correction lol. But she woke up at 150 and we'll see how today goes. with these numbers, that definitely looks to me as if her carb ratio is right on (at least for dinner). I'm going to have to see about the basal since we just switched it to morning so I need to see how that works for her anyway. Hopefully it continues to work like this because this is exactly what we need for school.
     

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