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So frustrated!

Discussion in 'Parents of Children with Type 1' started by susan0909, Jan 29, 2016.

  1. susan0909

    susan0909 Approved members

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    Any suggestions on random rapid rises in blood sugar? Can a 100 point rise in 20 minutes be due to a basal rate that is too low? It seems physiologically difficult to explain in that way but we are seeing it more and more frequently. Sometimes for no reason, sometimes 2-3 hours after a meal ( not a high fat meal). He drops to a normal range post prandial and then begins to rise back up. And then he becomes insulin resistant and corrections are difficult. My son is 10 and only about 70 pounds. We are running about 30 units a day now with basal rates that average 0.500/hr. His A1C used to be around 6.8, but now we are at 7.5 most recently. I am frustrated and out of ideas.
     
  2. kim5798

    kim5798 Approved members

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    puberty is starting...
     
  3. quiltinmom

    quiltinmom Approved members

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    Can you rule out snacking? He's at the age when they start the "always hungry" phase (which lasts a long time, so get used to it, lol). That's my first guess when I see fast rises. Boys can be sneaky. Don't rule it out unless you had eyes on him the whole time and know he didn't eat anything. I can't count the number of food wrappers I've found in my son's room...when I ask him, he says , "well, I was hungry." Even if your son is snacking and bolusing for it, you will probably see a spike. Sometimes I've had to sit him down and talk to him about eating--and sometimes I realize I need to ease up on the "rules" and allow him to eat more. If he knows I'm fine with it, he won't feel like he needs to hide it. (Okay, that makes me sound really bad...it's not like I don't let my kids eat...there's more to it, I just don't want to explain here.) Sometimes he isn't "hiding" his snacking, he just eats and I didn't know about it. At some point you can't hover over every thing they put in their mouth.

    For us, basal rates being too low are a more gradual rise. Even a bad site, where he's getting zero basal, is more gradual than 100 pts. In 20 min.

    However, increasing basal rates might be the way to combat the problem, if it's happening at roughly the same time every day. If it's completely random, no pattern, you just have to correct and do your best. It could be something physiological, as Kim suggested.


    Also, I should mention that we have later rises from food even if it wasn't "high fat" or pasta. I know on days when he eats soon before bed I'll probably be up correcting later, but if dinner was a 6 and bed is 9, if he goes to bed at a good number, he usually stays in range all night.

    I know I rambled a but but I hope you find something helpful.
     
  4. Theo's dad Joe

    Theo's dad Joe Approved members

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    My son is small too, only 54 pounds and turning 10 in March. I don't know if it is at all similar, but he always rises 3 hours after dinner and I've seen him go up from 100 to 180 in half an hour. My first guess is that it is hormones. Never happens at other meals yet, but he will get a little late spike 3 hours after lunch, kind of a second peak, but usually not out of range. My second guess for my son's case is slow digestion, or possible celiac, or something delaying absorption.

    How stable are your night time numbers? My son has started to occasionally have a bump in the early AM hours. He still is honeymooning enough to usually not go out of range.

    How does the Ping work out for your son, considering that my Theo is also small I wondered if that factored into the choice. Pros and cons?
     
  5. Sprocket

    Sprocket Approved members

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    An indication to me that basal is too low or running out too early is the creeping up gradually throughout the day (or night). Together with that is more corrections and seemingly continual chasing of highs until we return to normal overnight (through corrections). We've been battling this ourselves lately. Basal seems to run out too early or be too low by late afternoon into the evening. We're experimenting with higher basals and different timing of shots.
    On another note, we use regular insulin in combination with rapid for things like pizza, higher fat meals, days of regular graziing etc. It seems to combat the lows followed by highs with rapid only. It's interesting to see how regular works on the CGM.
     
  6. nebby3

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    I vote puberty hormones too. They can be active for years before you see outward signs of puberty. My cwd is a girl so I'm sure it's different but a sure sign of that time of the month coming for us is random spiky highs.
     
  7. sarahspins

    sarahspins Approved members

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    Such a rise in such a short time is probably not a basal problem. This last part of what you said here is very very typical of what a lot of us refer to as a "liver dump" - and to be honest there's not a whole lot you can do to prevent/manage them easily, other than to try to stay on top of changes. The highs resulting form those can be SUPER frustrating.

    As far as the why, it could be a lot of things - normal hormones (including puberty, but also cortisol, growth hormones, and so forth), stress, bad site absorption, etc. There are so many possibilities that it's difficult to narrow anything down to just one.
     

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