Blood sugar / insulin needs are all over the place

So we've been happily crusing along for awhile now:

  • 5-7 lantus at night (depending the next days anticipated activity level)
  • 1 to 30 for breakfast
  • 1 to 25 for lunch
  • 1 to 15 for dinner

All of a sudden, it seems like things are changing, but not in the way I'd expect. It always seems like she was lowest between breakfast and lunch, but now all of a sudden she's breaking 200 at lunch! Maybe part of the problem is that she's been responsible for making her own breakfast - and she chooses carbs. She's been eating 2 waffles (28 grams) for the last few days. She's been consistently waking up between 110-140, so she's not "high" to begin with.

Day 1 - I had her take two units (because waffles/bread always make her go a little high), and she's 206 at lunch.

Day 2 - We increase the 3 units for the waffles, and she's still 188 at lunch.

Day 3 (today) - She takes 4 units for the waffles, and she's perfect at lunch - 106. But that's like a 1 to 7 carb ratio!

What makes this so weird is that it seems like I don't need to adjust the lunch or dinner ratio. If anything, her lunch/dinner ratio might need to be higher, because she went down to around 60 yesterday between lunch and dinner, and then was 85 near bedtime - usually the time that she's at her highest point of the day.

Oy. I'm freaking out a little because she starts school next week and I need to decide on a ratio for lunch, but it seems like she's in total flux right now, so I don't have any idea where she'll be next week. I've started journaling all her food/bg/insulin again, partially because I am trying to figure out her trend, and partially because I am seriously hoping to get her a pump...soon!

Has anyone else had a similar experience?

[quote user="Michelle"]

Has anyone else had a similar experience?

[/quote]

Yes.   Happens to me.  Just when I think I've got it figured out and licked, things go haywire.  Usually I just have to try to adjust insulin levels a little bit and eventually it will straighten itself back out and I'll do good and think I've got it figured and licked, and then ...

 

 

[quote user="DDrumminMan"]

[quote user="Michelle"]

Has anyone else had a similar experience?

[/quote]

Yes.   Happens to me.  Just when I think I've got it figured out and licked, things go haywire.  Usually I just have to try to adjust insulin levels a little bit and eventually it will straighten itself back out and I'll do good and think I've got it figured and licked, and then ...

[/quote]

Haha.... yes, this sounds very, very familiar...

[quote user="DDrumminMan"]

[quote user="Michelle"]

Has anyone else had a similar experience?

[/quote]

 Usually I just have to try to adjust insulin levels a little bit and eventually it will straighten itself back out and I'll do good and think I've got it figured and licked, and then ...

 

[/quote]

This is exactly why I'm frustrated; because I can't adjust her insulin levels while she's at school because the school requires me to submit a form signed by the doctor and stick to it. I see some very creative carb counting in my future. Sure hope I don't get audited! :-)

 

Yup! Happens to me often too.

 

Sounds like your daughter is starting to hit the puberty stage though, which can also contribute to the changes in insulin. I had a heck of a time with my insulin doses when i was a pre-teen, but not everyone has a hard time.

She's going to spend the next couple of years bouncing around probably in her needs as her hormones increase. Talk to your endo about a new plan for school and take it step by step. I have a real sensitivity it seems to increases/decreases in my doses so I never adjust more than 2units at a time and wait a few days before making another adjustment. Since you can make adjustments over the phone with them, give them some copies of the form maybe and have them fax them into the school.

Why the school needs to be involved is beyond me(my school wasn't at all, we only had a school nurse once a week and I was pretty much responsible for myself at snack and lunch when i was 6!) but i guess things have changed.

 

One thing to note is that the more YOU stress out, the worse it's gonna make things for HER. As a diabetic who was dx at 6 and went through this with my mom..the more she was stressing and worrying, the more I felt I had done something wrong and I was causing all the problems. My mom never meant to make me think that way and always explained it wasn't my fault in any way..but that doesn't stop a kid from thinking that.

i did the same thing my mom haved a hard time with my insulin doses & im homeschooled i think my mom will go Crazy if i go to  public school i love being  homeschooled.

[quote user="Michelle"]This is exactly why I'm frustrated; because I can't adjust her insulin levels while she's at school because the school requires me to submit a form signed by the doctor and stick to it. I see some very creative carb counting in my future. Sure hope I don't get audited! :-)

[/quote]

Maybe see if the doctor can be creative with the wording of the form so that you have the freedom to change the dosages and ratios as needed.  When I was in school, my doc sent a note saying that my mom was in charge of everything so maybe yours could do something similar?  Your daughter's health comes before school rules in my opinion.  Her levels will never be stable for very long and this will be a pattern for the rest of her life - it's frustrating, but our bodies are not machines and will do what they need to do no matter how inconvenient it is for us!

 

Got to love this!!! I know for me still after 2 years. Once in a while out of nowhere I don't need insulin. It only lasts for a couple of days and then my numbers start to climb. I think it may have something to do with the way I hold my tongue!!! LOL Just kidding, but who knows. Hope all is well!!!!

[quote user="Batts"]

Sounds like your daughter is starting to hit the puberty stage though, which can also contribute to the changes in insulin. I had a heck of a time with my insulin doses when i was a pre-teen, but not everyone has a hard time.

[/quote]

That's funny, because my husband and I were just mentioning yesterday that she's been acting a bit hormonal. She's almost 11, so I guess she's getting close. It's just so weird that the morning is all of a sudden her highest time, when it's always been lowest. I just keep questioning myself. This morning I was absolutely cringing when she said she wanted 4 units for 28 grams. I thought we were going to have our first big crash - but I'm trusting her because it's her body. And she was dead on right!

And believe me, I'm laying all my stress on you wonderful people here. She'll never see it. I know better. :-) She's such an amazing kid and has such a great attitude about everything she's going through. We keep all things diabetes related very low key. I do worry, but I keep my worries to myself. I have a doctorate in managing stress from life university, lol. I've always had a stressful job and have been raising kids since I was 18, so I am a walking advertisement for stress management at this point. I could totally teach a class...

This infuriates me.  What kind of school nurse thinks that a single set dose is what you need?  This isn't a flu shot they are giving this child.  They are working with an active creature that is constantly changing.  They are thinking in black and white.  The insulin dose MUST be administered considering the current glucose level, the amount of carbs, the activity the child is undergoing, not to mention stress.  Aghhhh!  Reading this post angered me.  Good luck dealing with the school bureaucrats!  They think they understand diabetes better than a parent or the child?  Come On!