Monday, January 02, 2006

Am I stressing for no reason?

OK, so I'm pretty new at this. Does anyone else's child ever have a day where ALL of their sugars are in range? I've looked back at Riley's records and he's had ONE, let me repeat, ONE day where ALL of his sugars were in range. This includes the nice honeymoon period he had in the beginning where all he was having to take was his Lantus.

I guess it's important that most of his sugars are in range. But, he has at least one or two sugars everyday that are just out of whack. Is this normal? Am I expecting too much?

I don't want to bore you, but I wanted to give some examples of how his sugars have run the last few days. He currently takes Lantus 0.5 unit at breakfast. NovoLog 0.5 unit per 30g carbs. He is also on NovoLog correction for >225: 0.5 unit and >300: 1.0 unit. He doesn't take any NovoLog after 8 PM because his sugars drop so much during the night. For example, one night at bedtime, it was 312. (He didn't get any insulin, because it was after 8PM) At 1 AM, it was 261, at 6 AM: 96, and when he got up at 8 AM it was: 65. Yep, that's right, it dropped 247 points over night without any intervention. His range is supposed to be 80-150 pre-breakfast and 100-225 the rest of the day. OK, here it goes:

Fri, Dec. 30th:
6:51 AM: 130
8:24 AM: 124 (ate 30g carbs, got 0.5 unit of NovoLog and Lantus) (no snack before lunch)
12:38 PM: 134 (ate 28 g carbs, got 0.5 unit NovoLog) (had 10g snack at 2:00 PM)
3:48 PM: 75 (got another 10g snack)
6:19 PM: 241 (ate 41g of carbs, got 1.0 unit NovoLog [for carb coverage and high sugar])
9:10 PM: 212 (ate 15g snack)
10:17 PM: 319

Sat., Dec 31st:
8:23 AM : 148 (ate 31 g carbs, got 0.5 unit NovoLog and Lantus) ( no snack before lunch)
12:01 PM: 103 (ate 37g carbs, got 0.5 unit NovoLog) (got 9g snack at 3 :30 PM)
5:57 PM: 120 ( ate 30g carbs, got 0.5 unit NovoLog)
7:19 PM: 311 ( too early to give more insulin)
9:15 PM: 254 (16 g snack at 9:30 PM)

Sun, Jan 1st:
12:15 AM: 314 ( see how my New Year's started?)
6:04 AM: 223
8:33 AM: 146 (ate 38g carbs, got 0.5 unit NovoLog and Lantus)
11:13 AM: 324 ( no insulin because too early once again, got peanuts and Diet Coke. He gets VERY hungry and thirsty when his sugar is up. We were at church and Michael had to take him out because he couldn't sit still. Yet another side effect of high sugar.)
1:14 PM: 267 (ate 35g carbs, got NovoLog 1.0 unit)
4:31 PM: 63 ( drank yogurt[15g])
5:07 PM: 164
5:39 PM: 173 (ate 26g carbs, got 0.5 unit NovoLog[we decided to try 0.5 per 25g since his sugars have been up at night])
9:38 PM: 227 (ate 13g snack)

Monday, Jan. 2nd:
3:31 AM: 182
5:50 AM: 139
7:50 AM: 122 (ate 31g carbs, got 0.5 unit NovoLog and Lantus)

That brings us to the present. So, what do you think? Am I stressing for no reason? How perfect should I expect his sugars to be? The endo. has told me that "tight" control for kids his age is dangerous. But, that's why he has such a flexible range. His endo. also seems to think that if we could get his sugars up in the morning to justify a whole unit of Lantus, then the sugars may "even out" and "not bounce around so much". What do you think? I know that ultimately, I need to discuss all of this with the endo. But, I'm just wondering, is there anything to discuss?


Unknown said...

I agree with your endo, these little guys are so active my son's BS before the pump would always drop between 1-2pm no matter what I did...
The other day I had the hardest time trying to keep his BS up and all he had was 3u of Humalog all day at the Birthday party, and his BS were 86 and 91 like 4hrs after...but he played with his cousins for 2hrs+ I've learned that for Josh,now 2hrs after he eats if it's over 250, 2 tests in a row (I wait 15min), I give him a correction of .5 Humalog. I try and keep him between 100-150 if it's 80 I give him a snack. I don't stress too much if it's over 150 really anymore, because I would rather have it a little high than low since he's so active. I'm just curious, does your son recieve any more Lantus throughout the day or at night. With the pump,he's had a few BS over 400, becuase he knocked it out, and I was freaking, because in 2yrs, I'd never seen his BS that high, my husband had me relax, he told me do what the doctor told me to do and that Josh would be allright. Your'e doing a great job, it will get easier. It's a day to day learning process. I agree too, I know when his BS is high he ZOOMS!

Penny Ratzlaff said...

No, Riley only gets 0.5 unit Lantus in the morning. Why do you ask?

Anonymous said...

Hi Penny- just found your site today- Happy New Year, and what I really mean is good numbers all through the day and night, and a cure before another turn of a calendar page! I too, have a little boy with diabetes.
His name is Tommy. He is 4 1/2, and was dx. at 2 and 8 months.
Tommy is on lantus and novolog.
He too, has bizarre sugar readings, but he has had a few handfuls of days of perfect readings.
Who knows why?
I expect that every day, but this disease doe not want to get figured out. It is a beast of a monster, you know - a dictator really, who wants nothing but to cause misery.
In the new year, we hope for lots of good days, no trips to the ER , no pains in his legs, and a trip to Disney!
Please email at any time to talk!

Unknown said...

This was Josh's routine at 3yrs., He's on Humalog, I don't know how different that is, but he would get 3.0 units of Lantus in the morning and 1.0 at night, so at 8am and 8pm, about 6mos later he just recieved 4.o in the morning, which before the pump because of his growth increased to 7.0, but like I said he's on Humalog. Now with the pump, he no longer takes Lantus, which personally I feel, spiked in the afternoon, causing his lows, and wore off too soon early in the morning causing his highs in the morning. Since he's been on straight Humalog, his BS aren't perfect, but are more easy to predict.

Anonymous said...

It is very very difficult to keep such a little guy in range because so many things can affect their blood sugars. My boy was just about Riley's age when he was diagnosed and the first year was definitely a roller coaster.

Hang in there. One of the main frustrations of this disease is that just about the time you figure something out, another thing pops up to make you nuts.

Shannon said...

I agree with Terrilynn, it's a rollercoaster for sure.

Those numbers look very similar to Brendon's. He needs a lot more insulin in the morning, less during the day, and even less at night even when he's high because he drops so drastically through the night.

The numbers I see look great except of couse for the 300's.

It's OK to expect too much because his numbers will be better than if you didn't expect enough. BUT, don't beat yourself up if his numbers aren't what you think they should be.

When he's an adult, they'll be more stable than they are now. Now is about keeping him from getting too high or too low. There will be days where his numbers are great and the next day they'll be crap.

I think you're doing a fantastic job!