Puzzled Over BG Levels Reading

[irfanali]

Afternoon

My son was diagnosed on Friday with Type 1 so its all new to us, he's been fluctuating between 17 - 32 since we found out and basically advised to take 2 units if its below 30 and 3 if above as well as 8 units of Glargine at night before bed.

Now this morning he woke up and it as 7.2 🙂, he had 2 slices of toast with an egg, a cup of tea and 2 chocolate cookies

When he then checked before lunch @ 12.30pm the meter read HI which means he must have been above 35

The obvious question is WHY?, does it take time for the glucose levels to 'level out' or is the no of units advice wrong and he should be taking more or am I just asking stupid questions.

He currently takes 4 injections a day (3 insulin and 1 glargine)

Thanks in advance

 

[randomange]

Hi Irfanili,

Not a stupid question! I think at the stage you're at, asking questions is always a good thing 🙂

Am I right in understanding that - no matter what he eats - you give 2 units if his blood glucose is below 30, and 3 units if it's above?

If that is the case, then, IMO, then it's food that he has eaten that has send his numbers so high.

Has anyone explained carb counting to you? It's where you adjust the insulin you give him depending on how many carbs he's eating in a meal - breakfast was quite carby, so it's possible that he needs more insulin to cover it. 🙂

 

[bennyg70]

Its very early stages so there will be a lot to take in over the next few weeks / months and years.

The advice you have been given is very basic, I dont really know the theorys behind a childs diabetic managment anymore!

However to answer your question Why, Ill try and answer as if it were me.

In as simple as possible terms...

Very very Roughly...

1 Unit of insulin (Novarapid for me) lowers my blood sugar by 3
10 Grams of carb makes my blood sugar go up by 3

Therefore if your son had what you described for breakfast, then theres potentially around 80 - 90 g of carbs there, dependent on the type of bread, whether there was sugar in the tea, how big those cookies were! and any little snacky bits we might not know about..

So 8 lots of 10g of carb = a rise of 24mmol/l + the starting level of 7mmol/l

= Into the 30s mmol / l

For me to counteract that rise, I need my insulin.

so 1 unit covers 10 grams of carb. 8 units cover 80 grams of carb. I would need 8 units to cover this breakfast.

This is putting it simplistically. Your son may rise by 5mmol/l or 1mmol per 10 grams of carb, and his bg may lower by 5mmol, or 2mmol per unit of insulin..

I just hope this may give you an answer as to why its happened?

 

[Hanmillmum]

Hi there! 🙂

Our experience was much the same in the first couple of weeks after the diagnosis. It didn't help that my daughter was also ravenous and there was no filling her. We saw a lot of high readings.

We did have to keep a diary of what she was eating, the time and how much and the DSN would check in on us and look at this and eventually tweak the doses. The insulin regime for my dtr at the time though was a mix on a morning, rapid for tea and long acting at supper time. We then got the pump a couple of months in.

Things should settle down some time soon so hang in there x

 

[irfanali]

Thank you for your replies and advices

randomange & bennyg70 - Sounds like that may be the reason

Hanmillmum - Thanks

The nurse came round yesterday for a home visit to see how we are getting on and she has tweaked his doses to account for his now ravenous appetite

I've also got him into the habit of writing down everything he eats now

Fingers crossed

 

[Adrienne]

Thank you for your replies and advices

randomange & bennyg70 - Sounds like that may be the reason

Hanmillmum - Thanks

The nurse came round yesterday for a home visit to see how we are getting on and she has tweaked his doses to account for his now ravenous appetite

I've also got him into the habit of writing down everything he eats now

Fingers crossed

Hi

Sorry to hear about your son's diagnosis, I hate hearing of new children diagnosed.

How old is he?

It is very very early days for you but its great you are wanting to learn. Type 1 diabetes is confusing as it doesn't really do what it is told to. Life gets in the way. However knowledge is indeed power and the more you learn over the coming months will arm you to be in charge and not the diabetes which is what is happening now.

Fixed doses of novorapid are a bit daft (not your fault) and so many hospitals now show parents how to start counting carbohydrates at diagnosis or the basics at least as there will be lots and lots of tweaking needed.

There is lots of information for you on the children with diabetes websites both UK and USA

www.childrenwithdiabetesuk.org
www.childrenwithdiabetes.com

It will give you an insight to carbs and diabetes in general.

 

[fencesitter]

Hello 🙂 Early days as everyone says. I'm a bit puzzled about why 30 has been chosen as the benchmark, as it's sooo high. It might be to do with wanting to bring him down to normal levels slowly, but if he woke at 7.2 that may not be the case (great result btw). When my son was first diagnosed he also had a sliding scale, but it was a bit more optimistic than yours (ie. if bg is 4-7, take this much, between 8-11 take this much, between 12-15 this much and so on. I would definitely question this with your DSN, and as you've made such good records I'm sure she/he will be able to make sensible adjustments based on evidence. Good luck! This group is great for help in the early days (and the not so early days!)
Catherine (mum to William, dx aged 13, now 15)

 

[Tina63]

Hi there. It amazes me how different hospitals/teams give different advice to newly diagnosed children. I naiively believed at the start of our journey that everyone got treated the same.

My lad was diagnosed just over 2 years ago aged 15, almost 16. With him, they took some scientific calculation - something like 0.8 x bodyweight (kg) and then came up with a figure, in our case it was 54 or something. Halved that, 27,so 27 was the amount of Lantus (glargine) he was meant to have, the other 27 they divided by 3 (9) so that was the amount he was to have with each meal of Novorapid. Only days later we were all taught to carb count at home when the dietician came to visit with our son's nurse. The Lantus stayed at 27 for a while as they were happy enough with his morning readings, first of all we started altering his meal doses depending on the amount of carbs he was having. Then after a couple of weeks if his morning levels were a bit low or high, they altered his dose of Lantus, but only by one unit at a time.

My son got decent readings literally within days, with of course the odd 'high' here or there (but even then not spectacularly high any more - maybe just 10-12) but most readings were in single figures VERY quickly. Ok, not the first day or two but it was Christmas/New Year and we were eating rubbish food, lots of buffet stuff etc. I can't say he seemed to suffer in any way coming down fast either, he seemed so unwell before, this was a relief to see him obviously feeling better and his food and drink obviously staying inside him and doing what it should be doing to his body!

Things will settle down, but hopefully you get more detailed advice soon.

Tina

 

[irfanali]

Hi

Sorry to hear about your son's diagnosis, I hate hearing of new children diagnosed.

How old is he?

It is very very early days for you but its great you are wanting to learn. Type 1 diabetes is confusing as it doesn't really do what it is told to. Life gets in the way. However knowledge is indeed power and the more you learn over the coming months will arm you to be in charge and not the diabetes which is what is happening now.

Fixed doses of novorapid are a bit daft (not your fault) and so many hospitals now show parents how to start counting carbohydrates at diagnosis or the basics at least as there will be lots and lots of tweaking needed.

There is lots of information for you on the children with diabetes websites both UK and USA

www.childrenwithdiabetesuk.org
www.childrenwithdiabetes.com

It will give you an insight to carbs and diabetes in general.

Hi Adrienne

He's just gone 13 in Dec 2012

Thanks for the websites you have mentioned, will definitely take a look

 

[Fettuciniuse]

Hi Irfanali,

My son was diagnosed last March. He is 10. He is on the same insulin regime as your son. When we left hospital, we had to telephone in before each meal to the paediatric diabetes nurses with a BG reading, what he was going to eat, and what he had done/was going to do over the next few hours. They then advised what insulin dose to give.

Within a few weeks, a friend with a young diabetic child to whom I am indebted for this, really pushed the carb counting issue with me, and we have not looked back. It really is THE way to go with gaining control over blood sugars, and the independence to make diabetes fit around you - not you around it.

I cannot urge you to convert to carb counting strongly enough - it is absolutely easy peasy, and will enable your son to manage his condition effectively. Do you have a paediatric diabetes team at your local hospital you can speak to, or your son's consultant?

And sorry to read of your son's diagnosis - it is shattering news, and a shock which takes a while to wear off.
x

 

[soostark]

my son was diagnosed in novemeber, and his blood levels are all over the place!

yes it is mental how everyone is advised in different areas, we were told not to worry about carb counting for a long while yet, so at the momentt, his nurses tell us his doses,so i ahve no clue about all that, but it scares the prospect of having to manage it that way lo

 

[Hanmillmum]

my son was diagnosed in novemeber, and his blood levels are all over the place!

yes it is mental how everyone is advised in different areas, we were told not to worry about carb counting for a long while yet, so at the momentt, his nurses tell us his doses,so i ahve no clue about all that, but it scares the prospect of having to manage it that way lo

Still very early days for you guys, you will know when you are ready to take a lead x