Spike in the mornings

[ClaireBX]

Morning everyone!

If my questions sound silly I'm sorry, I'm still fairly new to learning and we are all just trying to find our feet.

My daughter is 1, and we are currently carb counting. She has 2.5 levemir in the morning and 1 unit at night. Then throughput the day she is on novorapid to accommodate meals.

Throughout the day seems okay, and at night she stays steady at around 6 sometimes 7.

However, in the morning I give her the levemir/novorapid then wait about 15 minutes to give her breakfast. She then shoots up about 15/20 mins after right up to the 20's. However, she does only stay there for about half an hour then shoots back down close to a Hypo. Its very much like a yo yo at the moment. She's newly diagnosed and we've only been doing this for about a month. I know this is silly high, but I'm at a loss as to how to keep this steady? I have tried to contact my diabetic team but I've not had a response on this yet. I'm counting the carbs correctly to counteract for this aswell. Any advice welcome! 🙂)

 

[trophywench]

Gosh ! - it's impossible to do that! - seriously, it is - as long as the BG comes down again after the initial spike, 15 minutes up there isn't going to kill anyone - remember that's one 48th of a day. However - how close to Hypo and how quick, are we talking here?

I do realise she's only tiny - but what do you give her for brekkie (actual food and the carb count of it) and have you tried giving her a tad less Novorapid before it? Presumably you have a half unit pen, so half a unit less?

 

[Bruce Stephens]

Gosh ! - it's impossible to do that! - seriously, it is - as long as the BG comes down again after the initial spike, 15 minutes up there isn't going to kill anyone - remember that's one 48th of a day. However - how close to Hypo and how quick, are we talking here?

I do realise she's only tiny - but what do you give her for brekkie (actual food and the carb count of it) and have you tried giving her a tad less Novorapid before it? Presumably you have a half unit pen, so half a unit less?

I also wonder how much of the spike is actually real, and how much is an artefact of whatever Dexcom is doing. (I don't have experience of Dexcom so maybe that doesn't make sense.)

Otherwise I agree. Even if you can't fix this, it's just a short spike and it doesn't matter much.

 

[ClaireBX]

Gosh ! - it's impossible to do that! - seriously, it is - as long as the BG comes down again after the initial spike, 15 minutes up there isn't going to kill anyone - remember that's one 48th of a day. However - how close to Hypo and how quick, are we talking here?

I do realise she's only tiny - but what do you give her for brekkie (actual food and the carb count of it) and have you tried giving her a tad less Novorapid before it? Presumably you have a half unit pen, so half a unit less?

It does come down after, but it shoots down not steady going down and she get to about 4 and we will give her a little bit of apple juice to keep her steady again. Her breakfast varies, sometimes she'll have original porridge, or weetabix. I've not tried giving her less novorapid I feel I'm not at the stage of being comfortable yet to adjust myself and I usually like to get it ran by the diabetic nurse prior but I've still not had anything back yet. We do have the half unit pen, I'll see if I reduce by 0.5 if this goes down. Her breakfast this morning was 17 carbs.

 

[SB2015]

The only thing I am wondering is whether a bit of a longer wait before breakfast would work. You could see what your team think.

Also is there any difference between a weetabix morning and a porridge day? I would expect that porridge would give a slower rise on the sensor.

As others have said such a short spike is not going to be a big issue but it is still disconcerting when you see this.

The drop after might require a change to the ratio. Another question for your team until you are confident to change these yourself.

It is very early days for you and you are doing well already. So much to learn so quickly at the start and then as you become more confident you will be able to tweak, which is lot easier with a 1/2 unit pen. For further fine tuning they are likely to offer your daughter a pump in the future.

Keep in touch and know no questions are considered silly on here.

 

[Libralady]

Morning everyone!

If my questions sound silly I'm sorry, I'm still fairly new to learning and we are all just trying to find our feet.

My daughter is 1, and we are currently carb counting. She has 2.5 levemir in the morning and 1 unit at night. Then throughput the day she is on novorapid to accommodate meals.

Throughout the day seems okay, and at night she stays steady at around 6 sometimes 7.

However, in the morning I give her the levemir/novorapid then wait about 15 minutes to give her breakfast. She then shoots up about 15/20 mins after right up to the 20's. However, she does only stay there for about half an hour then shoots back down close to a Hypo. Its very much like a yo yo at the moment. She's newly diagnosed and we've only been doing this for about a month. I know this is silly high, but I'm at a loss as to how to keep this steady? I have tried to contact my diabetic team but I've not had a response on this yet. I'm counting the carbs correctly to counteract for this as well. Any advice welcome! 🙂)

Hello Not sure if I can be of any help a the moment I am trying to encourage my stubborn 76 year old husband to keep better control of his type 2. What I wanted to say was that my son was diagnosed with type 1 when he was 2 years old. He is now 50. Thing were of course a lot different in the 1970s. No insulin pens had to use a glass syringe for injections which was sterilised in methylated spirit and only urine testing.
Seems so old fashioned now. Well I just wanted to say that I am sure everything will get sorted out for you and your little one. We got through it hypos birthday parties holidays etc. It never stopped him doing what he wanted he is married now and working full time plus being a member of a band playing the drums. I am not sure about you concern about her tests and her bs rising you are best to talk to your gp about that. I am sure you will have lots of questions as she gets older school etc.but there will always be someone like me here to tell you of their experiences with their diabetic children and offer support/advice. Take care.

 

[trophywench]

@Libralady - these days a newly diagnosed little child will absolutely be under the care of a hospital diabetes clinic with telephone access to them and NOT their GP. A GP does not have the expertise needed - and hasn't really ever since we moved on from one or two jabs a day of animal insulins, at the end of last century I have no idea what I accidentally hit to (apparently) quote myself before I'd even finished typing it!

 

[Rob Oldfield]

Morning everyone!

If my questions sound silly I'm sorry, I'm still fairly new to learning and we are all just trying to find our feet.

My daughter is 1, and we are currently carb counting. She has 2.5 levemir in the morning and 1 unit at night. Then throughput the day she is on novorapid to accommodate meals.

Throughout the day seems okay, and at night she stays steady at around 6 sometimes 7.

However, in the morning I give her the levemir/novorapid then wait about 15 minutes to give her breakfast. She then shoots up about 15/20 mins after right up to the 20's. However, she does only stay there for about half an hour then shoots back down close to a Hypo. Its very much like a yo yo at the moment. She's newly diagnosed and we've only been doing this for about a month. I know this is silly high, but I'm at a loss as to how to keep this steady? I have tried to contact my diabetic team but I've not had a response on this yet. I'm counting the carbs correctly to counteract for this aswell. Any advice welcome! 🙂)

Hi @ClaireBX

No more advice from me beyond what others have given you, but just to say that there are no questions here that are silly. You're facing a massively steep learning curve - and you will get it under control - but please don't worry about your questions. Just go ahead and ask them.

All the very best.

 

[trophywench]

@ClaireBX - yes I'm 100% fine with running it past your team of course and fully understand being frightened to do it - but the fact you need to correct the low with apple juice which then means she's had not just the carb counted brekkie but also the hypo remedy carbs to mop up some of the Novorapid does demonstrate that the dose for that original amount of carbs, is too high.

Speak to them on Monday and get it sorted for her.

You will get more confidence, cos we all have to and I freely admit that it's far easier for us adults using our own body as a scientific experiment than using your own baby as one! {{{Hugs}}}

 

[ClaireBX]

The only thing I am wondering is whether a bit of a longer wait before breakfast would work. You could see what your team think.

Also is there any difference between a weetabix morning and a porridge day? I would expect that porridge would give a slower rise on the sensor.

As others have said such a short spike is not going to be a big issue but it is still disconcerting when you see this.

The drop after might require a change to the ratio. Another question for your team until you are confident to change these yourself.

It is very early days for you and you are doing well already. So much to learn so quickly at the start and then as you become more confident you will be able to tweak, which is lot easier with a 1/2 unit pen. For further fine tuning they are likely to offer your daughter a pump in the future.

Keep in touch and know no questions are considered silly on here.

Thank you very much for your help and advice I appreciate it! Yes, I think it's potentially the choices in breakfast maybe, she loves egg at the minute too, but there's no carbs in that unless I add something to it for breakfast, I guess I xpuld consider that as a breakfast option. Thank you again 🙂)

 

[ClaireBX]

Hello Not sure if I can be of any help a the moment I am trying to encourage my stubborn 76 year old husband to keep better control of his type 2. What I wanted to say was that my son was diagnosed with type 1 when he was 2 years old. He is now 50. Thing were of course a lot different in the 1970s. No insulin pens had to use a glass syringe for injections which was sterilised in methylated spirit and only urine testing.
Seems so old fashioned now. Well I just wanted to say that I am sure everything will get sorted out for you and your little one. We got through it hypos birthday parties holidays etc. It never stopped him doing what he wanted he is married now and working full time plus being a member of a band playing the drums. I am not sure about you concern about her tests and her bs rising you are best to talk to your gp about that. I am sure you will have lots of questions as she gets older school etc.but there will always be someone like me here to tell you of their experiences with their diabetic children and offer support/advice. Take care.

Thank you very much for your kind words! X❤️

 

[Libralady]

Thank you very much for your kind words! X❤️

You are welcome Things have changed so much since my son was diagnosed in 1974. My son was under the care of the hospital clinic a lovely consultant. I only said contact your gp as you said you were having trouble getting a response from the Diabetic team. As trophywench said these days young children are under the care of the hospital as they were back in 1970s. Hope all goes well for youx

 

[trophywench]

@ClaireBX - why would you have to add carbohydrate to egg? In the absence of carb, the body makes glucose out of protein and/or fat - it only converts the carb first, cos it's easier for it to do!

In the late 1950s/1960s, the Egg Marketing Board's advertising slogan was, 'Go to work on an egg' cos it's always been good advice - protein for brekky, lasts your body longer than eg a bowl of cereal or toast & marmalade.

Oh gawd - sorry! I forgot she's on fixed doses. See with Nil carb - it means Nil bolus insulin - cos the body simply doesn't need it to convert either protein or fat to glucose - only for carbohydrate. And of course if you do keep diet entirely stable to begin with - it saves adding variables which may slightly confuse the issue.

Such a shame to restrict her diet for very long though - love the thought of her enjoying a (scrambled?) eggy in a morning - roll on your being taught how to carb count and adjust doses yourselves asap!

 

[Fatterthantheshadow]

In due course I'm sure your team will look at different types of insulin therapy, possibly pumps where you adjust the dose down to 1/10 unit, coupled with education you'll soon have it nailed down.
Everyones absorption is different, like your little one I have breakfast spikes, narrowed down to wheat being my worst ingredient, maybe you have the same thing

 

[helli]

Is the spike during or after a hot shower?
I have used a few different CGMs and found they all spike when I have a shower. I decided it is the effect of the heat on the sensor as my levels would not return to normal without insulin.

 

[SB2015]

Is the spike during or after a hot shower?
I have used a few different CGMs and found they all spike when I have a shower. I decided it is the effect of the heat on the sensor as my levels would not return to normal without insulin.

Now that is interesting Helli
I have not heard of that. I do take my pump off for a shower even though in theory I don’t need to, and I have put the slight rise a while later due to that.

 

[helli]

Now that is interesting Helli
I have not heard of that. I do take my pump off for a shower even though in theory I don’t need to, and I have put the slight rise a while later due to that.

For me, the Shower Spike is significant - typically 2 or 3 mmol/l returning to pre-shower levels without any insulin within 30 minutes.
And, having a patch pump, I wear it in the shower so do not have an insulin break.

I confess I enjoy a hot shower - my partner describes it as ”scorching”.

 

[everydayupsanddowns]

Sounds like you are doing amazingly @ClaireBX

Another thing to bear in mind (along with the reassurance that some BG wobbles are all but inevitable)… is that quite possibly the insulin you are providing may not be the only insulin that is in play?

In the first few years after diagnosis it’s not uncommon for the remaining beta cells in the pancreas to get a bit of a second wind, especially having been supported by the addition of insulin injections.

But of course insulin from beta cells is released in a much better place, and is more immediately available (and also switches off quicker), so I find myself wondering if some of these rapid drops from high levels might have an element of ‘honeymoon period’?

Hope you find a combination of doses, timings and breakfast choices that are able to reduce these wobbles a little and put your minds at rest.