Hi,
Because of covid my daughter is staying at my grandmother’s house while I’m at work. I’m having issues with her getting her insulin dosage correctly. I’m not sure if my grandmother is doing it incorrectly or shes not getting the proper dosage in the syringe. It happens everyday shes over there between breakfast and lunch she spikes. For example she will either wake up within range 80-150 or even sometimes be low, after she eats breakfast she gets insulin and by lunch shes 200-250. I prefilled the syringes for her , changed the times for her to inject her. Everything! It only happens over there. I’ve even tried changing her carb amount for breakfast , increasing her insulin dosage for breakfast nothing works. Please suggestions or ideas of what this could be .
A few thoughts come to my mind:
The first is that your daughter is sneaking snacks - kids can be creative and grandma may not know.
The other is that even if she’s eating the same thing at grandma’s that you fix at home, the recipe may be different. Or perhaps a different brand of the same item or ingredient has more carbs than the ones you use.
I don’t know if she might get into it, but I’ve found caffeine can raise my blood sugar, even if it’s a diet drink or “caffeine free” coffee. And I found to my great surprise that “the splash” of creamer I added was actually 7 tablespoons, at 5g each.
Just a few things to explore. I hope you find what’s going on.
Ndidi, I am in agreement with @wadawabbit DORIE. Children’s creativity is amazing, regardless of their age. I once heard about a 1 year old on a breathing monitor at home that would pull their wires to get parents to come running.
You did not share your young lady’s age. Depending on age, you may be able to place some responsibility on the wee lass.
Short story about responsibility. A 6 year old student who transferred schools mid-year pulled out a meter, strips, syringe, insulin, etc., did their finger stick, drew sliding scale insulin, and injected, much to the horror of the teacher. This occurred before 504s. The child knew what to do. Responsibility at that age, yes.
Hope this helps. Please share what you decide. It helps us all learn.
Wow, 6 years old? I think I started measuring out my own insulin when I was about 10 - with my anxious mom hovering over me wringing her hands, although I probably started doing my own injections a little earlier. At the time I took one injection of good old NPH at breakfast - I didn’t start on MDI until I was out of college and in the working world. How times have changed!
hi @stixxs512 you already have some great suggestions so I’ll just comment on other ideas.
kids grow and insulin requirements change over time. diabetes is not a disease where you take the same medicine at the same time and get the same results. It’s quite a bit of inject, test, adjust, test, adjust, test (etc.)
stress. stress can double my insulin resistance. took me months to figure out why yoga would make me go low. best answer: stress reduction and my basal rate was set to my usual “stress that could kill normal people” rate. Now your child may love her great grandma, but the top 1 thing that stresses kids is “change in routine”.
finally, digestive differences may cause a post meal “high”. but what happens to her blood sugar over the 4 hours that the meal bolus is active? if she comes down to normal at +4 hours after a meal… well, there isn’t much you can do about it except toy with glycemic index. so if at +4 hours she is within range again, the bolus is correct.
good luck I hope you find answers and can adjust to make this better.
The six year old transfer student was in the time of basic meters, no pens yet, & no 504s. The school had a no drug paraphernalia rule, expelled the child for possession of drug gear, parents sued, and just about ended up owning a public school district.
Settlement was expunged record, nurses in local schools, policy changes, & rudimentary 504 for the district.
How children learn & function according to expectations & motivation.
| wadawabbit Dorie Member with T1D
December 3 |
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Wow, 6 years old? I think I started measuring out my own insulin when I was about 10 - with my anxious mom hovering over me wringing her hands, although I probably started doing my own injections a little earlier. At the time I took one injection of good old NPH at breakfast - I didn’t start on MDI until I was out of college and in the working world. How times have changed!
Even young children with sufficient maturity have a greater understanding of their own medical needs than many adults (teachers and sometimes school nurses) around them might; so thank goodness for the 504s. Advances in understanding of diabetes has made it more likely that kids may need to do things while at school that we just did at home back in the day, so having that protection is awesome. Thanks to the parents and kids - from your example and others - who fought the good fight that got them in place.
Thanks for the suggestions everybody. So far I can rule out a few things I know it’s not my granny’s cooking because I cook her breakfast and send it over to the house . I’m pretty sure she isnt sneaking because my grandparents are very conscious of her foods and watch her pretty well. Plus my daughter was scarred for life at intial diagnosis in the hospital at 3 and knows the importance of not sneaking because she did it a lot as a toddler and it made her feel so sick when she turned 6 I noticed she stopped sneaking.shes very mature for an 8 year old and I think many kids with diabetes tend to grow up fast with everything they have to endur. I supplement foods enough where she doesnt feel that shes missing anything so she eats what I eat it’s just either made different or I just give insulin. Honestly I think its what one of you all said as far as a change of routine or stress. I have to wake her up at 4am for me to go to work then she goes over there goes back to sleep then wakes up at 8 for virtual schooling which starts at 9. I’m going to pay closer attention to her bolus which may need adjustment
Sleep - or lack thereof - can affect blood sugar. I was going to Google some articles for you but have to run out very shortly; however I’m sure you can find them.
Please look up “Dawn phenomenon” as a possible explanation. Adjustments for that made a big difference for me.
What is a 504? I was in elementary school when I was diagnosed in 1973. I had to check my urine to learn my levels. On multiple injections, but noon during school. Just morning and dinner, and later bed time. No insulin pumps or CGM during any part of my schooling.
hi @Cgrover a 504 plan is part of providing a binding legal agreement between the school administration, the student, the parents, the child’s doctor and the school nurse. we didn’t have them. We had no way to have accommodations such as have candy in class, or that we need to carry a needle in school. the 504 plan creates a agreement and T1 children (or others with different disabilities) can get what they need in any public school. anyway you can look it up if you want more: .https://www.google.com/search?q=504+plan&oq=504+plan&aqs=chrome…69i57.1283j0j1&sourceid=chrome&ie=UTF-8
Could also be the stress of a new situation. I am 64 and anytime I am around a relative I don’t get along with, mine can shoot up to over 300 without eating or drinking and being at 90 before I go over.
Wow, this condition is not anything to play with . My heart goes out to you
I am good. I just stay away from them! I hope you can find the cause of your daughter’s spikes but do know you brain can do good and bad things.
Thank you. Back when I was in school, there was no legal issues. We just talked with the principal and nurse in our school, and we all talked to the teachers. Before I was diagnosed, we had been limited on how many times we could go to the bathroom. Obviously, I needed to go a lot. Once I returned from my two week hospital stay, which was standard at the time, the principal came to me and said I could go to the bathroom whenever I wanted. Unfortunately, I was now in control, and didn’t need to go that often. I think all the legal issues didn’t start until I was out of school, and don’t have kids so didn’t ever really learn anything about it.
Ditto from me. We share a similar experience.
If she wakes up normal then spikes between breakfast and lunch does that mean her basal may need to be increased or just bolus? I guess maybe I’m asking could the basal be why the spiking is happening even if her morning number is always within range
@stixxs512, yes it could be only Bolus, could be only Basal, or it could be Both.
What is the period, length of time, between breakfast and lunch? And, might there be a little mid-morning snack of which you are not aware? If her spike is more than [just guessing] 80 mg/dl 2+ hours after eating breakfast, I would say that her breakfast bolus should be increased. But, if her BGL spikes because of rapid acting breakfast carbs and then comes down “just a little” after 2 hours and stays level at that higher than in-range level for a couple of hours leading up to lunch, it may very well indicate more basal insulin is needed.
Don’t adjust both bolus and basal on the same day - give a couple of days to see if your adjustments work before trying something new.
Breakfast is around 815 lunch is 1230. No mid day snack I watched her.woke up at 120 lunch is 240 . I even gave her a lower carb breakfast of eggs and toast just to see and she still jumped