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Eureka moment!

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T

Tina63

Well-Known Member
Relationship to Diabetes
Parent of person with diabetes
My son actually tested this morning - for the first time in 2 months! And his comment was "Well it's not as bad as I though given that I forgot to have any Novorapid with dinner last night!"

Not exactly sure of the reading, and it's not good, but at least he has tested, which in my eyes is another major step forward. It was apparently somewhere between 10 and 12, and he has said he will test twice a day for the next few days until we see the DSN on 24th.

Could someone give me some guidance on what you would expect (I know it can vary day to day, time to time, person to person etc) 1hr post meal, 2 hrs post meal etc if you were for example around 6 before eating. Just so I know what is ridiculously high for someone well controlled, and what is acceptably high. Given that he snacks all the time, I certainly wouldn't find a 4 hour slot when he hadn't eaten barring first thing in the morning. That's often his excuse for not testing "There's no point, I had a bag of crisps half an hour ago etc."

We were told the optimum was to stay between 4 and 8 pre-meals, but have never been told about the 'spikes' you all talk of post meals.

Thanks.
Tina
 
As you say, Tina, quite a breakthrough 🙂

This page http://www.diabetes.org.uk/Guide-to...ose_targets/?gclid=CJGI5uvlz60CFWQntAodXiPPmw

gives these as targets:
"Children with Type 1 diabetes (NICE 2004)
  • Before meals: 4-8mmol/l
  • Two hours after meals: less than 10mmol/l
Adults with Type 1 diabetes (NICE 2004)
  • Before meals: 4- 7mmol/l
  • 2 hours after meals: less than 9mmol/l"


Definition of children isn't given, so could be to age 16 years or to age 18 years.
Peaks are generally higher at 1 hour after eating than 2 hours after eating - so in your son's case, I'd advise against testing at 1 hour, so he doesn't get discouraged.
 
Can't give an answer on that Tina - it depends EXACTLY on what you ate, how much of it you ate and your very own metabolism.

But DUK say to aim for

http://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/Blood_glucose/Blood_glucose_targets/

Scroll all the way down the page and decide if he's a child or an adult LOL

These are very general guidelines and normally your own DSN will tell you the figures she expects to see for you personally. Nobody gets it every time. Tell me that you do - and I may not say it but I'll put you down as a fibber .... :D
 
Hi Tina,
I can't help I'm afraid as I'm type 2 but I'm really pleased that your son is making progress; I have been following your threads as I'm really keen to see how your son is doing; fingers crossed this is a sign of things to come. Amanda x 🙂
 
I'm type 2 as well..... so can't really help. but this is great progress x
 
A random reading of 10-12 isn't that bad, but it does put you in a bit oa a quandary. If his levels really aren't that bad, despite his lack of injecting and testing, then that is good news for his overall health, but he may also take it to mean that this is how it will always be and confirm his notion that he doesn't need to test.

But great to hear that he took it upon himself to do it! And I suspect he has been afraid of what he might see, so perhaps he will be encouraged and start to see if he can get things down into range. Who knows? :confused:🙄😉
 
I'm glad to hear this 🙂

I he's only testing twice a day, I'd say test pre meal only, e.g. breakfast and dinner (although I'd hate Carol going to bed without testing first)
If he's high at dinner time, he can correct it with the rapid.
 
A real breakthrough and maybe he's trying to help himself without being seen to back down.

Good for him and I hope the fear of the DSN's wrath is enough to get him doing a bit more.

As said, 10-12 is pretty good for a random test without injecting bolus but unless he tests more, there's no way of knowing if that's a spike or a low.

And testing half hour after eating would be better than not at all. It may scare him into inecting if he sees what the food does, although crisps wouldn't normally have a sharp rise.

Hope it continues.🙂

Rob
 
Thank you everyone for your advice and good wishes. The actual figure was 11.7, and that was his waking level this morning (well almost lunchtime) so I guess not great as he hadn't eaten at that time.

He is now at work until 8, but I will then ask him to test as soon as he gets home before we eat, as the Humilin should have just worn off by then. We kind of have this deal that he does test twice a day for the next 10 days or so, so I think morning and pre-dinner is best, if I can get him to do a couple more here and there, so well and good.

I have seen the figure with my own eyes, he invited me to have a look at his meter when I wanted to, so at least we are both being up front about it. I will remind him to inject for dinner tonight, so hopefully we see a better level in the morning.

We have also got our next clinic appointment through, for a month after seeing the DSN, so hopefully that will motivate him to keep some continuity going.

On the subject of clinic, we were told at his annual review last month that he would stay at the childrens hospital/clinic for the next 12 months. When we got this next clinic letter through, it's for the adult diabetes and endocrinology department at a different hospital. It does say with the paediatric team, so I guess this sounds like transition? Do you normally just get one appointment with joint teams then let loose on the adult teams? Also, how often do adults get seen at clinic, as he had been having quarterly appointments, just more frequent at present because of his poor control.

Thanks.
Tina
 
Tina -that's great news!

To be honest K had some numbers close to that getting up at lunch time during Xmas holidays, and thats with taking the insulin calculated for her evening meal, and having her Levimir :(

Someone else may explain the technicalities, but you can be quite high if you get up late because the liver has dumped some glucose because you haven't eaten and it thinks the body is starving(or something 🙂).

Or sometimes it might be growth hormones raising the blood sugars (having more insulin may be making them kick in - we have been told not having enough insulin will slow/stop growth).

So to (eventually) answer your question, 11 as a fasting reading once in s while wouldn't worry me to much but having that reading at 6.30 am (usual fasting reading time) two or more days in a row would make me re think our routine.

It really does sound like things are slowly improving, fingers crossed it carries on
Xx
 
Despite now being just over a year in, we have never had correction doses properly explained to us, neither have we ever been told to alter any doses/carb ratios ourselves, so we just sit tight and do what we are told by the hospital. I don't actually mind this, because if my son does as he is told to by them, we proved back in the summer getting HbA1c to 6.1 that it does work.

I do intend though emailing DSN before our visit telling her that this was never covered in any of our sessions, so that maybe she can incorporate that into the session. Without everyone on here, I wouldn't have known about correction levels, nor did I realise people tweak their own basals etc. We have just stuck with prescribed amounts of Lantus/Humilin and 1:10g carb ratio for Novorapid all day long. Whether my son would be prepared to test and correct though, is another matter!

Well that' s battle for another day (only joking!)

Tina
 
My son came in from work about 8.15 and tested without any hassle. I don't know the exact figure, but he said "A couple higher than this morning" so I guess that means 13 something - that's before dinner. We calculated Novorapid before dinner and I added 2 units extra on to the calculation. He actually injected that BEFORE eating too which is something he hasn't done for ages - in fact he asked me whether it would be a good idea to inject before eating rather than eating, so I said that yes, he should always a few minutes before eating.

So, it will be interesting now to see what level he wakes up at in the morning. He won't have his lantus until around 11 tonight so that's what will carry him through. I am really curious to see how things are now with some figures coming from him. Since he moved onto the Humilin as well as the Novorapid and Lantus it will be good to see what his levels are really like. It will also give the DSN something to base any changes on.

Will report back in a couple of days how his levels are going. Feel very positive about it all today though, he has been lovely all weekend so far, a real pleasure to be around and very sociable at home. Long may it continue!
 
That's great news Tina! Sounds like he might have decided to tackle it head on after all, I hope it continues 🙂
 
Makes you wonder who's had a word in his shell-like. Whoever it is, they deserve a shake of the hand 🙂

Could be someone at work who's made him see sense. Funny how they'll often listen to virtual strangers rather than those who really know them 🙄

Either way. Nice one.🙂

Rob
 
I wouldn't be surprised if a workmate had a good influence on your son, Tina - I can think of several situations when I have been helped with all sorts of comments from colleagues in paid or voluntary work and, I hope that the advice they sought from me, or occasionally that I gave unasked, has been useful.
 
13.4 last night and 12.3 this morning, not good figures despite him seemingly injecting.

I actually don't think he has told anyone at work about his T1, except putting it on his form because he had to. I asked him early on if anyone had mentioned it at all at interview, he said no, and I also said he should make the first aider aware, but that got a negative response. I truly doubt anyone at work knows.

We will see.
 
Tina63 said:
13.4 last night and 12.3 this morning, not good figures despite him seemingly injecting.

I actually don't think he has told anyone at work about his T1, except putting it on his form because he had to. I asked him early on if anyone had mentioned it at all at interview, he said no, and I also said he should make the first aider aware, but that got a negative response. I truly doubt anyone at work knows.

We will see.
Click to expand...

From those two (precious!) readings, it looks like he would benefit from an increase in dose of lantus - if he could bring those fasting levels down to around 6 then he would be in a much better position overall, since he presumably spends at least 8 hours a day sleeping. Might be worth running past the DSN now since he doesn't seem to object to injecting his lantus 🙂
 
Hi Tina,

Well, at least you have the BG informatioh, which is more than you had a few weeks ago! There's consistency between last night and this morning, which suggests that his basal is about right, hurrah!

Then in terms of the bolus for tea, maybe you need to up the ratio of insulin to carbs. E.g. if I currently use 1U to 10g, and dinner is 100g carbs then I would take 10U for that. But if I also took a 2U correction and the reading after eating is still only the same as it was before eating then actually that means I needed 12U for 100g, so my new ratio is 1.2U to 10g. Then an additional correction may be added on top of that if the pre-meal reading is high.

Hope that makes sense - I don't want to be giving you advice so I'm only saying what I would do with those readings. Try not to think of them as "bad" readings, just more data to work with for next time!
 
Oh sorry, just saw Northerner's post and realised maybe I mis-understood, I thought the 13.4 was after eating last night. Sorry, you need a pre and post-dinner reading before you could think about altering ratios, it's not clear which insulin needs adjusting at the moment.
 
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