New Onset

Hi, everyone,

My daughter, Dylan, age 6, was diagnosed 6 weeks ago, and is receiving 4-5 shots a day for now - Lantus in the morning and Humalog for correction at mealtimes.  We are really starting to see lows now - 49-60 range, and we are readjusting her basal insulin numbers every 2 days, and we are still seeing these lows.  Is this normal after a severe keto-acidosis event wheh she was first diagnosed (sugars were over 500)?



This is very typical.  Your daughter will need less insulin for a while because she will go into a "honeymoon" stage.  It will take some getting used to and it will continuously change so be prepared for a little bit of a rollercoaster ride.  My daughter was diagnosed in May of '08 at the age of 4.  She is 6 now, just like your daughter.  Let me know if you ever want to talk or have any questions.  I am on FB if you are....

Kathie Benjamin

I see this post is almost a month old now, but how did it turn out? are things starting to even out?

My only advice is that all you can do is just keep track of her BGs, carbs and shot amounts and then call your endo's office for help with dosing. Have they only been making adjustments to her Lantus or also to her Humalog?

A lot of lows happened to my son (age 4) as well shortly after diagnosis. We also found that while pre-dx we didn't usually have mid-morning snacks, that after dx, he needed this because when his Levemir would 'spike'. He was almost always low at 11 am, so we had to add a snack at 9am, regardless of his BG then (it could be over 200 at 9 and if we didn't give a snack he could be 70 at 11).



No - they are worse - we have now changed from 11 to 1 of Lantus, adjusted her carb ratios and she doesn't care to eat anymore - it's rough going right now - I guess we are in the Honeymoon phase and I feel I have no control over her numbers.  This disease is so frustrating and everything - stressors, illness, excitement, growth spurts - can change sugar levels.  It's amazing what a healthy pancreas really does...  I was going to switch to a pump in December, but now I am hesitant..

We are similar to your son, but before bed.  We have to have an additional 30g if BS>100 or 15g if 100-150.  She was waking up in the 60's and one night, and angel told me to check her and she was 47.  She is such an active kid - gymnastics, soccer, full og energy, so I guess she burns so much more than we think she does...

I am looking forward to some stabilization. 

Ugh - sounds nerve-racking.  I am sorry to hear that she is not interested in eating much - that makes it harder too.  Maybe one thing you could try, that we had to do for a while was not give Novolog after meals. It meant more checking because we wanted to make sure he wasn't going too high, but for over a week he hardly went above 200 and even if he did, he was usually down into range a few hours later, he was at his Grandma's that week and was playing outside pretty much the entire time, so his activity was really keeping things in check.  I'd be sure to discuss that with your endo, but maybe that would be worth a try, even if it is just for a few days?

The other thing to try at bedtime is a carb/protein/fat combo - not just  a carb snack (like juice or fruit snacks). So peanut butter on graham crackers with milk, or ice cream :) or some cottage cheese and fruit. The protein/fat can help slow down the carb absorption and might help with the middle of the night lows. Do you have a dietician that you are working with thru your endo's office? They might also have some suggestions.

And maybe the pump would be a good idea. You can give really tiny doses that are much more accurate than trying to give 0.5 or 0.25 units with a syringe (our endo also said syringes are no better than 0.5-1.0 accurate unit either way, so with our kid's tiny doses you can think you are giving 0.5 and actually are giving double!) This why we are moving to the pump (well that and our son hates shots).

Good luck!