Overshooting and going low from high

My daughter came home from a friends house at dinner time with her BG at 420 yesterday. This drives me bananas! I spent the entire evening trying to get her down. 

At midnight she hit 180 with double arrows down in the Dexcom so I gave her a couple glucose tabs and a 1/2 cup of milk. At 1:00 am she was at 79 and drifting down. I gave her a 1 hour  temporary basal of -20% and checked on her an hour later she was at 125 and drifting down again. This time I gave her a -30 basal and she woke up at 180. 

Needles to say I was pretty tired all day from this adventure and she is not allowed to go to her friends house with her CGM or she will be grounded. 

I really have a hard time bringing her BG down from ridiculous highs like that. If she is in the 200's it's not a big deal but when she goes over 300, what a pain! It takes so much insulin and then she goes low and we have to fight the lows. 


BY the way, I got thumbs down on the new forum. I liked being able to start a post and pick a category next. Now I have to pick a category first to even find the new post button. I think this is why there seems to be fewer users here than before the change. 

You played with a lot of food and insulin variables, which can cause trouble.  Next time keep it simple.  

When you correct give the insulin time to work, then test and use the correction wizard on the pump for it's advice on next correction.  

Do you have a good feel for how long the insulin is active in your daughter's body?  It can be anywhere from 2-5 hours with short acting insulin.  Make sure that setting is accurate on her pump so bolus wizard is accurate.

If my blood sugar is that high, I usually do the initial correction with a shot instead of the pump.  Insulin absorbs faster in fresh tissue.  Just make sure not to forget about that active insulin if other corrections are needed in the next few hours.

Also, I wouldn't mess with basal so much.  You do need to make sure that her overnight basal rate is accurate, but then let it be unless she's exercising or you need to suspend temporarily because of a low.  

Don't be too hard on your daughter about the high.  She just needs to bolus for dinner next time around.  When she's high try not to over stress.  It takes insulin, drinking extra water and most importantly time to get blood sugar back to normal.   Give her all 3 things and it will work out.

Take care.  -Jenna

It just seems that when she gets that high that she doesn't come down with just one bolus recommended by the pump. We check her every two hours and she doesn't start to come down until she has had at least another bolus. I have given her shots when she is high like this. I just don't like not having that insulin accounted for in the pump.

It's a weird situation.  Sounds like you handled it well overall.  Sometimes it's hard to be patient with getting a high blood sugar down.

In one of his books John Walsh talks about the "chinese restaurant effect" where it takes way more insulin to cover a large meal than what it should if you add up the carbs.  I've found that to be true with highs over 300 too.  For some reason, they take more than my normal correction bolus and way more than my usual 2-hour insulin duration to come back to normal.  

That's unusual. For me I find that the higher my blood sugar is the faster it drops when I make a correction bolus. Yesterday I came home from work and was at 280 I bolused for my correction and because it was closer to bedtime and I needed to eat I took insulin for my carbs as well. At 1 am I woke up to a bg of 45. Needless to say I was very frustrated since I had to wake up early for class.