- advertisement -

Stumped and need help figuring this out.

Discussion in 'Parents of Children with Type 1' started by CassiesMama, Dec 28, 2010.

  1. CassiesMama

    CassiesMama Approved members

    Joined:
    Jan 17, 2010
    Messages:
    363
    Ok my problem has been Cassidy going into the 300s every night around 3am or so. We tried splitting the lantus thinking that maybe it was wearing off too soon and the next shot not kicking in soon enough, but then we were ending up with highs all day long. During the day when she is awake if she is waking up with decent numbers she stays that way for the most part. I dont have her logs up here with me right now but its bugging the heck out of me that I cant figure this out. My gut is telling me the honeymoon is coming to an end, and I am really starting to feel like a noob with this all over again. :(
     
  2. Amy C.

    Amy C. Approved members

    Joined:
    Oct 22, 2005
    Messages:
    5,560
    After testing enough to know she isn't rebounding, the plain and simple fact is that high blood sugars need insulin to come down.

    I would increase the Lantus dose given closest to 3 am.
     
  3. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    Have you heard of the dawn effect? I've heard that younger kids get it earlier in the night, we used to seem to get it at midnight or so but now it's more like 3 to 5 a.m., apparently your body kicks out more basal glucose to get ready for the day and if the basal insulin is not there to happily greet it you get a high.

    The other possibility is a rebound if she's going low before the high, I'd check for that if you haven't already because sometimes when parents see a high at night they adjust to have more insulin then and it's actually because the kid had too much insulin in her a little earlier in the night. Seems unlikely for you, but I'd look once or twice (someone else can advise, but if it were me I'd check at 12, 1, and 2 or 2:30 one night to look for lows before changing anything else. . . . :().

    If you are seeing a dawn effect I'm not sure how you'd deal with that on Lantus. Do you give your Lantus in the morning, then? Have you been correcting that 300 and seeing her at normal numbers by morning, or leaving it be and seeing a normal number, or is she still high by morning?

    I know what you mean about feeling like you're starting all over again, I've been at this almost three years now and about every three months I feel like the learning starts from near scratch again. Fun times. . . . .:rolleyes::p
     
  4. CassiesMama

    CassiesMama Approved members

    Joined:
    Jan 17, 2010
    Messages:
    363
    We are night owls big time here. Being that we home school we run an bit more altered schedule then most do. So she gets her lantus at around midnight and heads to bed at around 1am or 2am. She tends to sleep till 1pm then we start our day. She has been waking up around any where from 100 to 150, but that is also with a 3 to 4 unit correction around that 3 or 4 am time slot.
     
  5. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    We keep odd hours some days ourselves. :p Did you get to see the lunar eclipse, then?

    I always used to give Lantus in the morning because we would get too weak at the end of the duration and too strong at first, so Selah would sometimes drop low a few hours after her Lantus shot and I wanted that to be during the day. She was little when we were on Lantus, too, so giving it in the morning meant she might creep up by early morning but that's when I was least likely to be checking her and catching lows so I was happy to have her run higher then and correct her with breakfast if she was too high. A lot of people here swear by giving Lantus at night but we really preferred it in the morning.

    If you are seeing a high about three hours after giving her the Lantus shot, I would definitely check intervening for a low and rebound. We saw our Lantus low at two hours, most people I think see it at five after the injection.

    Other than that, I guess it's a matter of needing more insulin. Is she eating right before she goes to bed? If she is, it could still be a ratio problem (or just a spike from the snack, but if you need to correct to get the number back into range it's not that -- well, unless it's a high fat snack?). But unless there's food and fast-acting involved, I guess it's more Lantus. If she has a higher basal rate at night than during the day, you wind up having to "feed" the Lantus during the day a bit, but that's easier to do than a correction every night. :(

    I'm probably not telling you anything you haven't already thought of, of course, but wanted to chime in and keep the thread active in these wee and empty hours of the morning! I'm sure others will have better numbers advice. :cwds:
     
  6. CassiesMama

    CassiesMama Approved members

    Joined:
    Jan 17, 2010
    Messages:
    363
    Maybe I have to change how many units she is getting if she eats closer to bed. Right now we got her at 1:12, maybe I need to change that for bed time snacks to more along like 1:10 or something along those lines.
     
  7. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    mine during growth would have a bg jump 1 to 1.5hr after she fell asleep, with you nightowl hours it looks like it may be that.

    I am not much help with shots, but wanted to let you know I have seen the after bed rise to 300 a few times a year sometime just for a few days, and sometimes for a month straight.

    Bought new shoes lately?
     
  8. Lisa P.

    Lisa P. Approved members

    Joined:
    May 19, 2008
    Messages:
    5,380
    That's funny!

    Are you seeing the 300s every night, or in nights when she's had a carb-heavy or fat-heavy snack right before sleep? If she has a carb free snack before bed and no short-acting insulin, what happens? I guess I wouldn't change anything until I'd elliminated a few variables. :cwds:
     
  9. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    Have you tried raising the dose? That's what I would do. Use a small increment- 1/2 a unit at a time if the total daily Lantus dose is under 7 units, 1 unit at a time if the total dose is 7-12 units, etc.
     
  10. Becky Stevens mom

    Becky Stevens mom Approved members

    Joined:
    Oct 14, 2008
    Messages:
    8,719
    Hey Chrystelle, sometimes lantus can take anywhere from 2-4 hours to really get working. Maybe you could move the time to earlier in the night, say 10PM and see if that works any better. She probably is ending the honeymoon and may not be as active now during the winter so will probably need more lantus
     
  11. peruvianpasohi

    peruvianpasohi Approved members

    Joined:
    Apr 20, 2010
    Messages:
    94
    When you split the Lantus, are you giving her 50% noon and midnight? It night help to try 40% night and 60% day. If you could get your hands on a CGMS unit, you would have a much clearer picture, plus the reassurance of the high and low alarms.
     
  12. CassiesMama

    CassiesMama Approved members

    Joined:
    Jan 17, 2010
    Messages:
    363
    Ok well I did up the lantus a bit more so she is getting 10 units now and she was around 160 at 3am so that helps :D Hopefully it stays that way.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice