sudden increase in insulin requirements?

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Patricia

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Have been away, so have no idea what's happening on these pages -- apologies! -- but all of sudden, my son's need for insulin has increased by over one-third. I mean, all of a sudden. We have raised his levermir by 20% two days ago, will do so again tomorrow because of little real change in numbers. Have checked vial of levermir and changed pens, just in case.

Fortunately just trace ketones. Testing regularly.

Correcting like mad with novorapid to try to stay on top. Nightmare. Up twice a night to check on these corrections.

He is thirteen. End of honeymoon (diagnosed for five months)? Growth spurt? School holidays/change of routine?

It would happen when we are 1) away and 2) over a long bank holiday weekend. We've left messages with all our care teams, but of course no one about.

SO frustrating. And of course he feels pretty awful. Exercise has twice been good at bringing levels a little lower, but of course need to be low enough to exercise! Argh.

How did anyone else's honeymoon come to an end? How about puberty?

Sorry guys. We've just been living and breathing this for several days. Finally back to computers.

Thanks for any thoughts.
 
It could be any of the things you mentioned, end of honeymoon, change of routine etc etc
You do seem to be doing all the right things though so good for you, just keep working at it and you'll get there in the end.
Looking back I think my honeymoon period came to and end quite quickly, my numbers certainly shot up dramatically at one point but it was also at a time when I wasn't really looking after myself, and didn't take much care over my diabetes so it's hard to say really. As for puberty, I was diagnosed at 21 so no help there I'm afraid!
 
Hi Patricia,
I wouldn't mind betting that the problem is a combination of all the things you listed :(
You are doing things just right IE checking and increasing the insulin as required.
Make sure your son is drinking plenty of fluids whilst he is high too.
From reading other forums and also talking to other Mums with teenagers not long diagnosed all are having higher readings at the moment plus xtra insulin requirements.
Very hard not to stress I know, but all you can do is go by the meter and adjust as needed.

Sue
 
SNAP! Alex hadnt been under 12 for 5 days - until yesterday when i decided we were going out for exercise we did and his levels were under 10! Also - and i cant stress this enough - i have abandoned the idea of an under 14g carb snack - it was playing havoc with his levels and it didnt make any sense to me that he was 'allowed' to have 14grams without insulin - so yesterday everything he ate was covered by insulin - so i will be asking his team why they say its ok for a snack without insulin! Also, regarding exercise if levels are high - i think its ok to do walking etc - nothing too strenuous - as long as there are no keytones present. This morning Alex woke and was 7mmls which hasnt happened for 5 days! Bev
 
Thank you all for this. I'm so interested to know that there may be something in the time of year -- last night in our flurry of research (!), we found the same: that there seems to be, amongst forum folk anyway, an acceptance of a 'summer growth spurt' that starts about now -- and sends it all haywire. Sigh.

The numbers have been TERRIBLE though. And he gets so cross and upset to boot -- not with us, to his credit, but with life. He is absolutely trying his best, and then these totally unexplained things. He always wants to go in with huge corrections, etc and we have to pull him back...On top of it, of course, each correction seems to affect him differently (not just on whether with or without food, for instance) -- afternoon corrections having more effect, etc...

Walking did him good the two days we managed to get things down enough to actually do a walk (things were 19+!). Both days that is what kept his numbers okay (though he hasn't been in target range in a week!).

The most hair-tearing thing is how much we only know through hindsight. For two or three days we thought that his evening meal was affecting the morning, because the afternoons were slightly better (and he was having a snack in the afternoon, so we accepted slightly higher numbers then). It was only when he had a pre evening meal measurement of 17 (ack!), when he hadn't eaten in five hours (novorapid worn off completely) that we realised there was a serious levermir deficiency. There are SO many variables.

I know I'm not saying anything that all of you haven't experienced. Please excuse my rambling.

Woke up on 11 this morning -- the best in a week, if you can believe it. Upped levermir again.

Bev, I completely agree about the 14g snack. We have found if walking etc he can snack without trauma, but have noticed over last months that of course any snack will affect levels. If he's stable, a snack will raise by 3mmol or so, temporarily, but if bouncing around at all number-wise, a snack will mess things up badly. This is partly why we are so DELIGHTED to be in line for a pump very soon; he needs to eat, but it messes him up, and correcting with each snack for us leads to 'stacking' novorapids, which can have really unpredictable results and make the levels going into a meal also difficult to negotiate...

Something I forgot to mention too was that by the holidays I was convinced he was losing weight, looking rather gaunt. He was working hard at school, performing in concerts, and I think not concentrating on eating much (also very wary of bg levels, not wanting to raise them, responsible by nature), having small meals and racing to next thing. As soon as school finished, he just ate like a HORSE, constantly hungry, and though we corrected it all, I suspect that just having a larger overall carb count on board will have skewed things?

So. We've all really felt this -- our first holiday since his diagnosis, a place we know well and wanted to really get our teeth into again with lots of walking...It was hard, esp for his younger sister, though she was very good about it, not to do what we all wanted. Saying that: we played lots of games, lots of family time, so hey. And one day, despite bad numbers, we whacked them down and he went on a Go Ape with Dad, came out saying 'diabetes didn't stop me'. That was worth it!
 
Hi Patricia

Delighted to hear about your son and his dad enjoying "Go Ape". Never done it myself, although I have done lots of rock climbing, abseiling etc. Just back from a 4 day kayaking and camping trip along River Ouse - fun, despite almost constant drizzle until last hour of paddling and packing boats on & kit in cars. In Thetford Forest, near the Go Ape, there's a permanent orienteering course (POC), and lots of other POCs around the country, so perhaps your family would enjoy the sport too? Search at http://www.britishorienteering.org.uk/event/poc.php
 
Patricia
He could also be sickening for something which will put his BGs up. I always need more insulin if I'm ill or sickening for 'flu or something.

As far as your son is concerned, there is a very good forum (USA based but with a UK section) where teenagers can chat to each other. He may find it helpful http://www.childrenwithdiabetes.com/
 
Copepod said:
Hi Patricia

Delighted to hear about your son and his dad enjoying "Go Ape". Never done it myself, although I have done lots of rock climbing, abseiling etc. Just back from a 4 day kayaking and camping trip along River Ouse - fun, despite almost constant drizzle until last hour of paddling and packing boats on & kit in cars. In Thetford Forest, near the Go Ape, there's a permanent orienteering course (POC), and lots of other POCs around the country, so perhaps your family would enjoy the sport too? Search at http://www.britishorienteering.org.uk/event/poc.php
Click to expand...

Small world, I've just come back from a week's holiday in Thetford forest!
 
Hi Patricia

I was going to mention sickening for something as well. Sometimes if you are coming down with something then the levels can be horrendously high 3 odd days before anything actually happens. This is with most illnesses except vomitting and diaarrhea when levels are generally low beforehand.

This isn't the same for everyone though.

Coming out of honeymoon can be that quick as well or a combination of all of them as someone else suggested.

Sounds like you are coping really well although it may not feel like it.

Take care
 
Not an area Im really able to say anything about, but how lovely to read about your holiday! I do hope those numbers stop mucking you about soon! x
 
Thanks for your support and thoughts, all. Copepod: I'm desperate to try Go Ape! But I'm waiting until my younger child is old enough. Thing about this last time is, my son and dad also did it before diagnosis, about two years ago. So it was a proper confirmation of things being okay that despite high numbers, he did it again... I appreciate your link re orienteering, and will pass it on.

Adrienne and Pattidevans: yes, we'd wondered about illness, but it's been going on a long time. He has been slightly under the weather for weeks really(little cough and stuffed up slightly), after being knocked out in early March by a flu type thing. But he seems to be steadily improving. What I may do anyway is ask for some bloods to be run, (or anyway DSN may suggest this, once we finally get hold of someone!) to see if there's an underlying infection of some sort.

Numbers slightly better yesterday, able to head out for swim which of course helped in the long run. Still quite high in the night though. Sigh. The second increase of Levermir yesterday should start to kick in properly today, so we'll see.

Pattidevans, thank you too for the teen link. I know the site bit didn't realise this area of the forum was in real use. I'll pass it to him. He's slowly beginning to reach out -- tomorrow at this focus group in London, and we are all at the JDRF day in Cambridge Saturday.

Aymes and Sugarbum, thanks for the support. I think we know what's happening, it's getting it to work (like a gigantic sudoku) that's wearing us out now...
 
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