Help!!!

[Gillsb]

I am faced with a very moody teenager at the moment. Type 1 for 2 1/2 years, 4 injections a day. We are really struggling with it all at the moment and I can see her becoming very anti diabetes. Levemir seems ok as she is waking up with good levels (usuall). 2 hours after food not bad (usually under 10) but other times all over the place. This morning, mid morning 16.9 then down to 4.9 before lunch after which she went hypo. 2 hours after dinner tonight she was 10 and now gone up to 15. Are we doing something wrong. Not had these problems before.

I really am struggling with it all.

 

[bev]

Hi Gill,
Could it be hormone related? Otherwise i would say its a growth spurt and she needs an overhaul of her basals and bolus. We are battling highs at the moment and are in the middle of changing things - so i know how you feel!😱
What food did she have tonight - perhaps this is the reason she is 15?The only other thing is -has she come out of honeymoon yet?🙂Bev

 

[Adrienne]

Hiya

My own personal opinion is that as well as all the hormones kicking in etc the mid morning spike then down to hypo by lunch is very typical of MDI (4 injections).

It helps to inject the novorapid about 15 minutes before eating breakfast (or any meal actually). If you can get the spike down then you will increase the chance for a midday hypo which is why lots of people on MDI absolutely have to have a midmorning snack of about 15 carbs (snack bar, crisps etc). It is a matter of practicing. Maybe the NR ratio for breakfast needs to be looked at as well.

Do you carb count? Do you have a carb to insulin ratio for all the meals (probably different ones for each time of day). If not then this will help sort out the problems a lot more. Ask you DSN to teach your carb counting. It seems daunting to begin with but its a piece of cake once you get the hang of it.

I hope you get this sorted for your daughter 🙂

 

[Gillsb]

I have spoken to DSN ab out carb counting and she is certain that we are doing it correctly. I dont have specific ratios but have always assessed the food and the amount of carbs and come up with an insulin dose that fits. I must admit this has always worked for us up until now and the DSN wants us to stick to this.

Breakfast is normally the same each day and we have started to try and inject before which helped the highs afterwards. Now that she has good levels two hours after, we have started to see highs later on (last night she wnet up to 16) although she was 10 after dinner.

Found her hiding in her room last night sobbing her heart out and she told me she wants to give up! Its so heart breaking to see and I found myself lost for words because I can understand totally how she feels. We have chatted and agreed that today is another day although woke up in a hypo which wasn't the best start. Probably because we did a correction on the high the night before.

Not quite sure what I am asking, guess I just needed to get that all off my chest. Just wondering how to get back to good levels after meals and then throughout the day without these highs in between. Is it possible that a growth spurt can affect things like this as the chances are she may be growing.

 

[sofaraway]

What it might be worth doing is for a few days working out the exact carb count of her meals and then writing it down with the insulin dose given. You might find some surprises in how much carbohyrate is in soem things and how you are matching up your insulin does.

How is her basal? some questions to think about, can she skip/delay meals without having hypos? can she go to bed in range and then wake up in range?

if she is growing it can definatly cause highs because growth hromones increase blood sugar levels.

 

[Adrienne]

I have spoken to DSN ab out carb counting and she is certain that we are doing it correctly. I dont have specific ratios but have always assessed the food and the amount of carbs and come up with an insulin dose that fits. I must admit this has always worked for us up until now and the DSN wants us to stick to this.

Breakfast is normally the same each day and we have started to try and inject before which helped the highs afterwards. Now that she has good levels two hours after, we have started to see highs later on (last night she wnet up to 16) although she was 10 after dinner.

Found her hiding in her room last night sobbing her heart out and she told me she wants to give up! Its so heart breaking to see and I found myself lost for words because I can understand totally how she feels. We have chatted and agreed that today is another day although woke up in a hypo which wasn't the best start. Probably because we did a correction on the high the night before.

Not quite sure what I am asking, guess I just needed to get that all off my chest. Just wondering how to get back to good levels after meals and then throughout the day without these highs in between. Is it possible that a growth spurt can affect things like this as the chances are she may be growing.

Ah bless her heart. Sounds like she needs to meet others who are in the same boat as her. Do you know any girls her age locally? If you pm me and let me know where you are in the country, I might know some near you. The email group I told you about has about 300 odd members around the country ranging from tiny tots to children of 20 !!!