Levels on the increase - yet again- what should we do?

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hkk1970

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4 months in and we are still fighting a battle getting Harrys levels right.
He is 4. Just when we think we are nearly there , things go to pot and feel as though we are back to square one.

I would appreciate your thoughts, ( whilst the diabetes nurse calls me back from a message I left on Friday !!)

His day time readings are not too bad, following on from our last hospital appointment , his carb ratios and basal were increased . His evening basal was increased to the highest it has ever been.

We are now finding the following.

He eats his tea at 430pm - correction often necessary

630pm readings between 5-10 ( his target )

He has 10g slice of bread for supper - obviously with insulin

8pm rise to approx 13

10pm rise can be anything between 13 & 23 !! ( Here we correct)

Morning readings are between 5-11

We have already increased basal by 0.01 from 6pm-1am, with no change at all/ carb ratio increase too at tea time and supper.

What do you advise, increase the basal again ?

Hopefully the DSN will call me soon ! I really want to try and get this right before he starts school in september.

thanks
Helen ( Mum to Harry 4 - diagnosed 2012 0 pumping since Feb 2013)
 
hkk1970 said:
4 months in and we are still fighting a battle getting Harrys levels right.
He is 4. Just when we think we are nearly there , things go to pot and feel as though we are back to square one.

I would appreciate your thoughts, ( whilst the diabetes nurse calls me back from a message I left on Friday !!)

His day time readings are not too bad, following on from our last hospital appointment , his carb ratios and basal were increased . His evening basal was increased to the highest it has ever been.

We are now finding the following.

He eats his tea at 430pm - correction often necessary

630pm readings between 5-10 ( his target )

He has 10g slice of bread for supper - obviously with insulin

8pm rise to approx 13

10pm rise can be anything between 13 & 23 !! ( Here we correct)

Morning readings are between 5-11

We have already increased basal by 0.01 from 6pm-1am, with no change at all/ carb ratio increase too at tea time and supper.

What do you advise, increase the basal again ?

Hopefully the DSN will call me soon ! I really want to try and get this right before he starts school in september.

thanks
Helen ( Mum to Harry 4 - diagnosed 2012 0 pumping since Feb 2013)
Click to expand...

Not growing is he? Do boys get a bit of a testosterone kick at 4-5? (sorry... we had girls so I don't know how it goes).

To my mind (and I realise that this is rubbish and the last thing you want to hear) there is no 'right' with diabetes. Only ever 'right for now'.

It's a constant round of firefighting, juggling, tweaking and fiddling. All. The. Time. I have just had a pump clinic review, in preparation for which I did a double set of fasting basal tests to cover the 24 hours from late May to early June. Most of these showed pretty much bang-on stability. (not sure whether they are practical for a littlun though)

But...

My results over the weekend/this morning suggests the goalposts have shifted again as rather than being slightly on the low side I am now just the opposite. I never expect my 'right' to last for more than 3-4 weeks at a time.

And I haven't got growth spurts meddling with things!!

Sounds like you are doing all the right things to solve those issues. Just keep on keeping on and enjoy the gaps where corrections/ratios work well for a while. 🙂
 
Hi Helen,

I remember those early months when I consoled myself with the thought that we'd soon have it cracked 😉. But as Mike says, the goalposts keep shifting, so whenever Harry is growing or we're having a spell of hot weather, or cold weather, or an illness brewing, etc etc. you will have to tweak things I'm afraid! We were told that in pre-adolescent children, growth hormones are secreted during the first phase of their sleep, increasing insulin resistance during this time. The advice we were given was to set a higher basal rate for 2-3 hours about an hour into his normal sleep. E.g. If bedtime is 8pm, a higher basal from 9-11 was recommended. You will have to experiment with exactly how much of an increase he'll need, and you can bet that once you have his BGs back in line, something else will change!

In the meantime, prepare to need longer trousers and bigger shoes! :D
 
Hia Helen, nothing useful to add really but just to re-affirm what others have said. I find its a never ending round of changing basal rates without going longer than 4 weeks of 'getting it right' before its all changes again. I don't seem to be able to pin it down to any reason in particular for the change either most of the time. Sometimes it's weather (maybe), other times its that time of the month and my DSN tell me that it could also be down to hormones at the age of 48.
For me, it helps to set several blocks of time so at the moment I have 12 basal rates set. It sounds a lot it it works for me as I'm changing smaller slots at a time and I seem to be able to handle that better than trying to work with longer time slots. Obviously though, we're all different, and if the same basal rate works through the day for some then so be it. All the best with it and keep trying - tough enough for anyone but to have to try and do it for a 4 year old must be really tough.
 
Those reading dont seem to bad to me , morning reading very good. Have you been on a carb counting course. Depends on what he eating/doing. He is probably to young to running around in the park etc. He is a lot better off being on the pmpp with couple of pushes of buttons. I dont think anybody gets perfect results. Good luck & dont be hard on yourself 🙂
 
Hi,

I may have said this before, but my 4 yo is very much the same in the early evening and her basal is double what it is the majority of the rest of the day from 08.30 - 11pm. It is what it is, and she needs what she needs. If you are consistently finding high readings at this time increase the basal to counteract it. Doesn't matter if it seems higher, if that is what he needs, it is fine. Looks like the rise may be coming in before 8pm? So then you may need the tweak before 8pm and include the high hours until it steadies off from climbing.
 
Thanks for your advice everyone.

Now this is diabetes for you, I complained yesterday about his levels on the increase and what happened last night, kept going down until we got to 4.1 at 4am and had to wake him for a rich tea biscuit !! Was 7.7 this morning..

I wonder whats going to happen tonight !!!

Will I ever sleep again !!!


Helen
 
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