I need a little help please. Riley has a doctor’s appointment in another week and I’m going to run this by his endo too. In the meantime I want to hear what you guys think.
Since Riley was diagnosed his eating pattern has pretty much been breakfast, snack, lunch, snack, supper, snack. Since school started the morning snack has been eliminated. He eats breakfast around 7:00 then lunch at 11:00. He has snack at around 2:15.
I rearranged basals to accommodate for the new schedule. At first he was low at lunch and high at snack. I did a little more rearranging and had better results for the lunch. Now, he is almost always in range at lunch. But, for snack he is usually in the upper 200s or lower to mid 300s.
I have increased his insulin as much as I’m comfortable doing. I’ve increased his lunch carb coverage a bit. Still, he has these stubborn highs. He’s had a few days where things are pretty good at snack, but most days he’s high.
He has recess in between lunch and snack. You’d think, if anything, he’d go low instead of high after activity. I don’t think he’s going low and rebounding because when he does that the resulting high usually lasts a while and takes several doses of insulin before it comes down. These highs come down just fine with insulin. By supper he’s normally back in range.
His teacher called me on Tuesday to let me know how great his sugars had been: 120 at lunch and 87 at snack. She was thrilled and so was I. Riley was out of school Monday. Holden had him eat on his usual schedule and his sugars were just fine. In addition, he got out ½ a day on Friday. His lunchtime sugar was great as was his snack time sugar.
It seems that when he is not in school his snack time sugar is just fine. So, what is it about school that’s causing the rise in his sugar? It is not what he eats at school. Riley is allowed to eat from the cafeteria 2 days a week. The other days he takes his lunch. The highs occur whether he eats a lunch from home or not. Also, when he eats at school but gets out early (early release is at 11:40) his sugar is fine at 2:15.
Any ideas as to what is going on? His teacher called me on Wednesday. His snack time sugar was 345. He had PE prior to snack and she said they had run around the football field several times so she was afraid that he would go low. Instead he was high. She also said that the day before when he his sugar was good at snack that they had not been outside to play at all.
I’m at a loss as to what to do next. Do I keep increasing his basal from 11-2? Right now it is at 0.400 units per hour. That’s the highest basal he’s ever had. On the weekends when he’s not in school his basal at the same time is 0.275 units per hour.
I’ve told his teacher to start having him check his sugar before and after recess to see if that tells me anything. Do you guys have any other advice?