My son has has three days of highs after food. Ketones are at 0.1 but I don't know what is causing him to go so high. Any advice on how I can keep his BG down. He even had a high of 19.9 after dinner which was a shock.
Yes he's type 1, diagnosed in August 2020. He's BG has been good for a while so this is a big shock. He had a cold which I thought was the cause but that has gone so I'm really lost on the cause. Seems like he spikes with every meal.
Type 1 on aspart injections and levemir evenings only. They recently stopped his levemir during the day as it was causing him to have lows after breakfast. He was diagnosed in August 2020 after sever DKA. Part of me is thinking he is coming to an end of the 'honey moon period' but can this happen as fast as this?
So an hour after food he's at around 12-13 and then after 2 hours he's at 14-15. He varies and has needed corrections as his BG is still going up. After dinner is when he usually needs a correction. I've been trying to give him meals when his BG is in a good range so he doesn't go as high.
Is he getting back into range before his next meal? Or at least coming down.
I would agree with @Kaylz it sounds like there might not be enough basal. Could also be the end of the honeymoon period. Other things to take into consideration are a broken vial of insulin or pen. I had this mysteriously happen to me once and my levels were running high teens. I discovered that the vial of novorapid in my pen was cracked. Just a thought.
Definitely sounds like he has come to the end of his honeymoon period - no idea what the average length of time this takes for a child but as onset of D is so much more rapid than for most adults like me - why wouldn't this stage be quicker too? (anything in Ragnar Hanas' (bible) book to give us a clue?)
Yes yes yes! Very urgent phonecall to his team ASA humanly P, as already said.
Have a chat with his team. I can’t see how old he is. It may be that he’s grown or put on weight and his needs have changed especially for his basal. Or it may be the end of his honeymoon period but the only certainty with diabetes in children is that their needs will change.
How soon after dinner was he getting lows and what was he eating? With some food we split the dose (much easier on a pump but you can do it with a pen) as my daughter will crash after eating as the insulin hits before the food and then she’ll go high after as the peak of the insulin has already passed by the time the food hits. The other thing you can do with this is change when you give the bolus. But it’s much easier for your team to have all your data and see exactly where you need tweaks.
Upload your data in the morning and then have a chat with your team. I presume you have out of hours contact details for them if needed. This isn’t so urgent that you need to call them tonight but it would have been appropriate to call over the weekend so don’t hesitate to get in touch with them over holidays/weekends if you need to. We had a chat with ours on Friday evening as we were having issues.
We’re lucky if we get 2-3 weeks without some ratio or basal change so it’s very common to suddenly hit a patch where it all goes haywire as they hit growth spurts or their levels of activity change etc.