Had enough

[Amanda102]

I am posting at this time of night because I am facing another night of practically no sleep and testing my daughter's bgs throughout. The period of extreme highs (20 plus) continued during our holiday last week and I was at my wits end. In the end I increased her basal by 100% and tinkered with her carb ratios and saw some better results towards the end. On Wednesday all her pump settings were changed properly by the nurse to accommodate the increased dosage and the next day she had great readings... Then wham! Hypo at 2am this mornings and numerous hypos throughout the day. I have just had to wake her to give her some glucose as she is hypo again. I have now reduced her basal by 50% and am waiting to test again. I have no idea what is happening and I am frustrated and exhausted. Is it possible that her increased insulin requirement was only temporary (albeit it lasted about 2 weeks) and she is now going to come back down to needing less again? I have no idea and feel completely fed up. Can anyone give me a clue what might be going on?

 

[Northerner]

I'm so sorry to hear about the problems you are having I know that a lot of children experience wide fluctuations in insulin requirements when they are coming out of the 'honeymoon' period, when the pancreas may be spluttering a bit with producing its own insulin, making things very unpredictable.

I can't offer any words of wisdom as I have no experience of this, but I do hope that things settle for you and your little one very soon.

 

[ypauly]

I have real problems with high levels when I am on holiday from work I think it's because of inactivity, but there is a massive difference between when I am active and inactive. I have different pump programs that reflect this.
I'm not convinced that is the problem you face but insulin resistance does change with temperature and activity so may be a factor. I hope you get sorted soon though.


I have approximately double the amount of insulin at inactive times to that when I am at work.

 

[pgcity]

It is so frustrating when this happens but you are doing a good job. You may not be able to pin down exactly what has happened which is extremely frustrating to say the least. Have you ruled out a bug or any hormonal changes? Some people have big swings when the weather changes too.
I hope things are better soon.

 

[Twitchy]

I wonder....maybe it's puberty kicking in? I know my menstrual cycle makes (for me) a marked impact on the doses I need...I tend to run high before my period starts & then my levels all drop when it kicks in. Or alternatively it might be a growth spurt or something? Another 'usual' candidate for me running high is a bug, the effect on my levels doesn't always equate with how bad the bug feels either, so a mild bug could have quite an effect still?

Hope things calm down for you both soon. X

 

[trophywench]

I was going to say - three things LOL

1. Puberty - most T1 ladies find they need a hike in insulin sometime after ovulation (generally mid-cycle) On a pump you find out what she needs by experimentation with temp basals month by month (recording them so you can see what you are doing) and once you have a fair idea of what she needs and at what stage in her cycle she needs it, program in another permanent basal rate, then you can automatically switch to Base rate 2 on day whatever, and back to Base Rate 1 at the end of that.

2. Growth hormones - play havoc when they decide to.

3. End of honeymoon

Turning to possibility no 4 - the weather ..... I find whether it's added heat (meaning I need less insulin) or added cold (when I need more insulin), goes berserk for about 10 days but then if the weather continues, flattens off after that so any extra or lesser needs wear off and I gradually go back to square one.

 

[Caroline]

I hope things are improving for you. As a parent of a non diabetic child I keep an eye on things. There are lots of viruses and bugs doing the rounds and kids pick things up. It is possible there was some kind of bug in the system that didn't come out fully.

 

[Ruth Goode]

I'm sorry you're going through it but remember you're not the only one. It's happened to my daughter too and I know it was scary but the good news it will settle again. Diabetes is like a rollercoaster!!

 

[AlisonF]

Firstly, keep going, you're doing a brilliant job, I'm not sure there is much that's harder than managing someone else's diabetes for them.

As others have said, it does sound suspiciously like the changes I'd associate with the menstrual cycle. I was diagnosed aged 4 and when I was about 12 my parents noticed a similar pattern to what you're seeing - about 9 months later my periods started, with exactly the same pattern. For me, my diabetes showed sign of my menstrual cycle many months before it appeared. Keep a record and see if you see anything similar over the coming months.

 

[Amanda102]

Thank you all. At the weekend I reduced her daily insulin down to 35 units a day ( She had been on 26 before all the highs and had gone up to 50 since) and adjusted all her pump,settings accordingly (just discovered that I have the formula from the last settings the nurse sent me on an excel spreadsheet - ha!). I thought we'll aim to just stop her having all the hypos and then gradually increase or decrease over the next few days as needed. Miraculously she has been spot on for the last couple of days now and I was confident enough to have a glorious nights sleep last night! I think probably hormones and/or growth were to blame. I will keep a record as suggested. She has not started her monthly cycle yet, but I would expect her to within the year the way she is going and it may be related. Thanks again for all your advice and comments I am feeling hugely relieved at the moment (until the next time!).

 

[Copepod]

I realise that omitting night time tests makes an undetected hypo more likely in your daughter, but you can't go on having disturbed sleep every night, so I was really pleased / relieved to hear you'd given yourself a night off. And your daughter - she might sleep through a test, of course, but if not, then never getting a solid night's sleep will be affecting her, too. If she wakes and feels hypo, then, as long as there are sweets (or something sugary) she can reach without getting out of bed, then she can treat herself. Perhaps test and brush teeth after, when feeling OK.

Unfortunately, growth spurts and puberty make for very confused endocrinology (hormones) in anyone's body, and honeymoon period from recent type 1 diabetes diagnosis complicated matters even more.