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Stacking insulin?

Discussion in 'Parents of Children with Type 1' started by VinceysMom, Jul 17, 2010.

  1. VinceysMom

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    I have another question about this Cedar Point adventure... if we have lunch say 1 pm, and then an hour later he sees the cotton candy, can I give him another shot right away? And then what if he then wants the snow cone or something else say 30 mins after that?? :eek: Do I have to wait to give him this stuff? or would all this be stacking insulin and then dangerous? I know I would just bolus for carbs, no corrections. I want to have fun and be relaxed so I am trying to get all my questions answered before we go...

    And then, if the cotton candy is 158 carbs, would I do 1:15, 1:20 or what? Our breakfast is 1:15, lunch is 1:10 and dinner 1:8 if that helps. Do we use our sliding scale? OMG i am having anxiety with all this.

    Thanks for the help!
     
  2. Sarah Maddie's Mom

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    Stacking only applies to corrections. If he's eating, even if it's serial eating, it needs to be covered and is not "stacking" :cwds:
     
  3. Mimi

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    What Sarah said. :cwds:

    And relax. Don't let d overwhelm the fun and enjoyment of the day. I try to pick the ratio that is closet to the time of day or sometimes I'll split the difference and do something in between. With "food" like cotton candy and snow cones you're going to be doing a lot of guesstimating.

    Have a great time. And relax!! :cwds:
     
  4. VinceysMom

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    Thanks, Ladies, you are so kind!
     
  5. kim5798

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    from our experience, i would say estimate low on the cotton candy...seems like a lot of carbs, but you have a lot of air there.

    kim
     
  6. Sarah Maddie's Mom

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  7. kiwiliz

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    Could you take a little pair of scales? If the cotton candy is just sugar 10g (weight) = 10g carb. You only have to do it once and then you know what the standard is (especially if you get your stuff from the same vendor). DD said she has weighed a big bag of cotton candy from the fair before and it is around 20 - 30 grams carb. (Remember they use a lot of energy running around!) Have a wonderful time.

    PS if you are sneaky and fill them up with hot dogs(5g/c plus bun amount) or pies first(45 - 50g/c) the GI goes down, slowing the absorption of all the sugar AND they can't fit too much else in! ;)
     
    Last edited: Jul 17, 2010
  8. hdm42

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    As the others said, stacking is only with corrections.

    I always guesstimate on the low side when we're at an amusement park or some such thing. There's so much extra walking and activity that he uses a lot more energy and sometimes goes low. Test often.
     
  9. VinceysMom

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    LOVE this idea!! lol

    Thanks again everyone... I'm hoping he will think twice and say no to the cotton candy... yeah right, who am I kidding! :p

    Stay cool! It's sweltering here...

    Kathy
     
  10. goochgirl

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    really? after 2 years of this I still don't get some of the basics.... the shame.
     
  11. Sarah Maddie's Mom

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    Oh, Gooch .... the things I didn't know after two years ... could fill a book:p
     
  12. hawkeyegirl

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    Just to expand a little, the reason that dosing for carbs is not "stacking" is that the body needs insulin to process carbs, whether they're eaten within 30 minutes of each other or 4 hours of each other. So if you eat 30 carbs, a half hour later eat 15 carbs, and an hour later eat another 30 carbs, you have to dose for all of them so that the insulin matches up to the carbs.

    With respect to corrections, it's a different ball game. Suppose you test and your child is 250. You give a 1 unit correction. In most kids, it will take 3-4 hours for that insulin to completely finish working. So you check again in an hour and BG is now 200. It's still high, but there is still quite a bit of insulin still working to bring BG down from that first correction. If you give another full correction, you will have, in essence, corrected twice for part of that high. That is stacking.
    Make sense?
     
  13. mmgirls

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    One other thing to consider.

    If you give multiple boluses to cover food over a period of time and lowerer than expected numbers are seen that can not be explained due to activity or guesstimations, than your I:C may be off.
     
  14. caspi

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    I think that this is such important information for MDI'ers to have. We were always taught that, on MDI, there should be a minimum of 3 hours between doses. It was no wonder that my son's AIC's were elevated!! It wasn't until I learned this here that I changed our way of doing things and his A1C, of course, dropped!

    Thanks for posting this! :cwds:
     
  15. VinceysMom

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    Thank you all for your input and information...Not only have you helped me, but many others as well. Today was our Cedar Point day, and guess what...He never even asked for cotton candy OR a snow cone! :p We drank tons of water, it was so dang hot!!! When we went to test before lunch, he was 250:eek: so I am thinking the diet pepsi I bought him may not have been diet after all?:( Who knows! But all in all, it went well. Only treated one low of about 75, and that's it! Phew, we made it thru the first amusement park adventure since dx!!!

    Thank you again everyone,
    Kathy
     
  16. hdm42

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    Well done! :)

    You survived, and you'll be even more confident next time. Yes, there will be a next time. :cwds:
     
  17. Lucky 868

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    I'm confused about this, too. My son, 16, diagnosed last April, takes Lantus and Humalog. The CDE explained that you cannot give a "correction" dose within 3 hrs., but I don't understand why it is OK to give a "carb" dose within that time period. Say he's got no correction in him and we give the usual ratio at lunch. 2 hrs. later he wants ice cream. If he takes Humalog for the ice cream, how do you adjust the dose knowing that he still has some in him from lunch? So far, we haven't had this happen but I'm confused how it works.

    Thanks for the help.

    Lucky 868
     
  18. NomadIvy

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    Because we need insulin to convert the food we eat (that is, the carbohydrates -- whether in simple forms or complex forms) into something our body can use and not just "spill out" into the bloodstream (thus elevating blood sugar levels). So every time our CWDs eat, we need to give the proper dose of insulin for it depending on the I:C ratio they have. The only time we do not do this is when we're giving the carbs to cover a low blood sugar.

    The insulin he took during lunch is for the food he ate during lunch. Now if he asks for ice cream 2 hours later, then you need to bolus for the ice cream and NOT make any corrections to whatever his BS levels are at the time he's eating the ice cream.

    However, for those who are aggressive or want very tight control, they will sometimes "stack insulin"... but giving a lower percentage of the needed insulin, and this depends on how many hours have passed since the last dose was given. If this last paragraph has made it more confusing, ignore it :p.

    Now...can someone please explain to my dear hubby that bolusing for food two hours later is NOT stacking insulin! :rolleyes:
     
  19. canadianmomto6

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    I think many of us were told at dx not to give insulin again in less than 3 hours which causes the confusion about insulin stacking. I know that we were told the same thing. It was only through CWD that I really understood the difference. I would guess that in the beginning they don't want you to bolus too frequently because if you don't have stretches without bolusing it makes it difficult to see if basals are set properly.
     
  20. VinceysMom

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    Exactly! Even this morning, my son wanted 4 piece of italian bread toast and hour after his cereal... I told my husband, yes, it is ok... no it is not stacking insulin. I finally had a good explanation of all of this from all of you! The endo's office did make it sound like we couldnt give more insulin with 2 -3 hours of the last injection. Thank goodness for this Forum!

    Thank you!;)
     

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