Do you do a

correction before bed? I dont for Riley because the lady we were seeing said no more desserts at bed time so she wouldnt have any fast acting that late or before bed. When we switched from NPH to levemir. She made it sound like you are not suppose to do it so I am curious if its done and she is crazy or if she is right lol. More often than not Ri is around 300 at 8 pm and goes up some by 9 then she drops over night down below 200.

Also what is your correction ratio? Rileys is 1 unit for every 50 she is over 150. I am curious on the differences between individuals.

Yes, I do corrections before bed - but I am a lot less insulin sensitive than your daughter.  :)  When I do a correction at night, I actually have to do more than I would if I stayed awake.  My correction factor is 1:25 over 110.

my correction is 1:30 over 100. i do corrections before bed because more often than not i keep rising during the night.

I will do corrections before bed if I am high.  But my target is set to 120 or 130 instead of 100, just to be safe.  Overnight blood sugars can vary a lot based on food eaten, exercise, etc. (exercise is the most dangerous).  Keeping those things in mind, I think correcting is fine, but it does depend on the person. 

I do corrections before bed. My ISF is 66:1, and my target is 92, all day long. I am dreading the day when I will inevitably have to rework those numbers... Since switching to the pump, I can't think of a time I've woken up low, except after drinking, so nighttime hypos are not a huge concern for me. 

Rapid acting insulin is much more predictable than long acting insulin. With lantus/levemir, you can get variations of up to 40% in efficacy - with humalog/novolog/apidra, it's more like 10% (don't quote me on that.) So correcting highs overnight on MDI, when you know you're less aware of lows because you're sleeping, can be dangerous. If she's not dropping down much below 200, I would probably try out a correction - but that means getting up to test overnight until you're sure she's not likely to drop too low. 

Is Riley's target 150 all the time, or just before bed? Also, do you know why she's usually at 300 before bed? Is dinner especially carb heavy, or does she get less exercise after dinner? Does she need more insulin with dinner? or is she just sometimes high, not always? It might be that instead of doing a correction at bed you could lower her I:C ratio at dinner (more insulin) a little and see the 300s less often. 

Ajax I honestly think he levermir stops working to soon or so it seems from what I have read its closer to 18 hours not 24 and seems to be so with her. She is almost always overly high at bed time some times in the 250 range but mostly closer to 300. Even when she eats something like a salad (26 g carbs) for dinner and I give her 2 units for it. I almost always round up for her insulin.

She hasnt been able to do pe at school lately cause she has been running to high at 9 a.m. as well one day it was cereal (kashi go lean) and the next pigs in a blanket. She was over 300 at that time too.

Yesterday I had to give her 7 units of insulin with her after school snack a bag of cheezits 20 something carbs. That was at 3:45 at 6 she was still high cant remember exact numbers right this minute.Pretty sure it was in the 300's tho

 

Her target is yeah nothing above 150 all the time. Without looking I would say in the past month that might have happened 3 times. I however like her at 180 at bedtime. She seems to have lows if she starts out at 150 or really close to them.  At 180 she doesnt.  So the only time she is close to her target is in the mornings oh and yesterday at lunch she was 95 because I went and gave her a correction of 3 units tho it was suppose to be 4 at 9 a.m. I did it a unit shy because her lunch isnt until 12:40 and knew that she wouldnt last the whole time without a low if I gave her the 4units.

She has not had any ketones in her urine tho I want to do a random check this morning after she gets up because I forgot to last night when I checked her at 9 she was at 309 and already asleep.

I dont mind getting up all night long to check her. If she plays really hard during the day she almost always ends up low at night so I wake up every 1-2 hours for the 6 hours I am asleep to check her no matter what she starts at. I was thinking of just doing one unit if she is over 300 and go from there testing her all night. I will wait for the weekend tho. I was going to change her ratio all day long to see if it helps to 1:10 she is actually in between 10 and 15 now cause like I said I almost always round up.

Brandan is extremely sensitive to insulin. His correction is 1:150 over 200. (Keep in mind he's not even 4 yet.)

If his BG is high at his 8:00pm check I will check it again around 9:00pm. If it's going down on it's own, I won't do anything. If it's higher than it was I will correct if it's over 300 with 1/2 the usual correction dose.

I always check him at 10:00pm before I give him his night dose of Levemir. I do the same thing for a high BG at this time of night as I do at bedtime. If it's a little too low I'll check again in about 30 minutes, and again if I feel it's necessary. I can mostly sleep easy after a good number. If he starts waking up with high BG then I will add a 2:00am check.

I don't know if this helps you at all, just sharing. :)

It sounds like she might need a little more both basal and bolus insulin. 

When i was on levemir (the two days i took it before realizing that i'm allergic to it), I was told to take it twice a day. If you're going to be doing a shot at bedtime anyway, why not split the levemir? If i remember correctly, I took 12 units at 10pm and 14 units at noon (which is morning. oh, college). On lantus I only took one shot, somewhere around 20 units at 1 pm. 

i do correct before bed if i am over 200 usually. i sometimes have a snack with protein with it too. also, if i have been playing sports or being active within 4-ish hours before bed, i dont correct just in case.

the one thing i remember form being on shots and correcting is that they told me (at the hospital) that i shouldnt take insulin without eating something.. i do that sometimes tho..

my correction is 1:40

I was thinking about splitting her levemir up I know lots of people do. She started at 25 units on it but got really active and after many sleepless low nights I dropped it to 21 and have bumped it back up to 22. I know this summer she will be more active and her numbers will get better over the summer from that alone.

Most of the time she doesnt seem to be sensitive to insulin at all.

 

I had her numbers wrong from yesterday at snack time 3:45 she was 267 so I gave her 2 units for a correction and then for the cheezitz it was 1.7 . I gave her a total of 5 units at dinner time 6:00 pm she was 320. So it was a full extra unit and it didnt take her down she went up. So I am going to try 1 unit for every 10 carbs and see if that helps and bump up her levemir one unit. I will start with the levemir for a few days tho and then see if it has helped if not then I will change the novolog. At 9 last night tho she went to bed at 309 and woke up at 6:30 at 237.

 

 

Why don't you start "low" if it seems like she needs a correction before bed? Ask her dr, but maybe you could start w/ half of what her normal correction would be during the day. It sounds like she's staying high enough at night that you have some "room for error." Then, you could see if she needs more or less.

There's nothing worse than waking up after being high all night. :P

I will correct before bed if I am above 150. My target BG during the day is 90, but after 9 pm it's 120 and my sensitivity is also double what it is during the day. I rarely eat before bed if I can help it, so I had to change my setting on my pump because I was going low during the night.

Usually before bed if I eat a snack I take a little less than normal because I have a tendency of going too low in the night/morning. I am also 1 for every 50 over 200 as my correction.

Sarah as soon as we can get insurance again and a endo I will ask one lol. My husband changed jobs and I tried to get them on the state chp+ but we were denied. Tho we shouldnt have been so I have to deal with all that. SO I am on my own for right now and only making the changes I am comfortable making until we get her a endo.

[quote user="Jessica "]

Sarah as soon as we can get insurance again and a endo I will ask one lol. My husband changed jobs and I tried to get them on the state chp+ but we were denied. Tho we shouldnt have been so I have to deal with all that. SO I am on my own for right now and only making the changes I am comfortable making until we get her a endo.

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OMG, I didn't know that! I think you just need to try and give her more a little more insulin then if she's running high.

Can you call her former endo for a phone conversation while you wait to get on insurance?

I correct for 1:50 if I am over 120.....

[quote user="Sarah"]

OMG, I didn't know that! I think you just need to try and give her more a little more insulin then if she's running high.

Can you call her former endo for a phone conversation while you wait to get on insurance?

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I am not sure we just went to the DNE from the hospital. I think I will email her and ask her advise. I also applied for ssi for all three of my kids and of course they denied Riley because they dont see her as being disabled. I kinda see there point but at the same time she isnt like other kids and diabetes has stopped her from doing things like normal kids. The lady from the hospital told them Riley was under good control which is not true. We have not even seen her since February. That was when she switched her from the NPH to the Levemir. So yeah I have no clue what I will do between now and July if we cant get her on something. I know the new job has the same insurance as our old one which doesnt have a preexisting clause so we will be able to use it right away for her with no waiting period. Thankfully my hubby is making enough we can buy all her supplies and insulin ourselves without it killing us.

you can fight the "not being disabled" verdict. she is eligible for assistance through the department of vocational rehabilitation because t1d is considered a disability (i receive assistance through the IA dept of voc rehab). i would think you can use the same criteria from DVRS to support your SSI application.

Hopefully my boys get approved for their autism, adhd and epilepsy. If they do then covering just her stuff will be doable for us. If not I will challenge all 3 of them. Heck I would be over the moon happy for just medicaid for all three of them. We just couldnt swing 460 bucks a month for all their needs with insurance. With out and for only 2 of them its going to run us 1500+ thankfully my hubby is working government jobs for right now and gets paid more than his regular wages so we can cover it.