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Yet another illness question...

Discussion in 'Parents of Children with Type 1' started by steph, Sep 16, 2012.

  1. steph

    steph Approved members

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    DD had her first illness since dx. Roseola. She had moderate fever sept 7-9, and then a mild rash on the 10th and 11th, and no other symptoms besides reduced appetite. Her BG was high during her illness, and she did develop ketones on 2 occasions. We kept her well hydrated, gave extra inulin for the ketones and corrected for high blood sugars. I was actually pretty proud of myself for handling her first illness without freaking out, and not having any major issues. Especially because we were out of state on vacation (also our first trip since dx)

    But her sugars have been high ever since. Her diabetes team has told me to keep doing corrections and not to change her ICR bolus at this time, but this has resulted in maybe 1 BG reading a day being in range with the rest well over 200. I hate chasing highs and would rather try to head them off with a decreased ratio for carbs consumed instead of doing corrections. I am supposed to send in her BG log Monday and discuss what changes to make. My question is, how long do highs from an illness tend to last once the illness appears to be over? And how long do you wait with high numbers before changing ratios? Her bedtime numbers are pretty stable, so I don't think it's a basal issue. Usually the third day of a high at a particular time, I will change the ICR of the previous meal. But her highs are all day, and the corrections aren't even bringing her down all the way. She's on .5u for every 100 over 150.
     
  2. Sarah Maddie's Mom

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    It's possible that the illness was a stressor on her honeymoon and remaining beta cells and that the increase need for insulin is no longer related to the specific illness but to a progressive decline in her pancreatic function.

    I can't point to any studies to support this, but from reading here for years and from my own experience with how D works, it seems quite likely to me.

    From your description it sounds as if her body had been helping out at meal times with a bit of insulin and now may no longer be.

    Hope your team can help you make the needed changes.
     
  3. MomofSweetOne

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    I agree with the previous poster. Between the length of time since your daughter's diagnosis and an illness, it's likely your daughter's requirements have hit an increase. The same thing happened to us. We went from 3 units of basal to 9 within days. Heartbreaking, to be sure. I hope we're wrong, but stay in contact with your team and don't let your daughter run high for too long. The little ones can't express it, but my daughter is miserable by the time she's in the 200s for even two hours. You may be seeing it in the bolus dose first, whereas we saw it in the basal first.
     
  4. cdninct

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    I agree. DS got a bug 5 months after dx, and I kept waiting for it to pass so that his numbers would come back down into range. It never did, and we wound up past the honeymoon stage with a kid who was high all the time. Our clinic advised making the "permanent" (ha!) changes, but I was reluctant to do so, hoping in vain that the honeymoon wasn't over. Eventually, I had to accept what evidence was suggesting and roll with it.

    I'd never advocate going against doctors' advice, but I would suggest that if you do opt to make changes to ratios and then it turns out she was simply still feeling the effects of illness, you can always change things back. As long as you are monitoring for potential lows, it does not seem like a big issue to me!
     
  5. steph

    steph Approved members

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    This morning she woke up normal 119, and by lunch she was 450. Ugh. So we are starting out by changing breakfast and lunch ratios. Hopefully we can get her back to having normal numbers soon.
     

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