My son has been sick for a while. He's got a bad cough, ketones ranging from moderate to trace, and blood sugars that go over 600. He's been on 30 units of Lantus for a few weeks now, They moved his insulin:carb ratio to 1:15. We seem to get a handle on the levels, then he gets symptoms of being sick again and it all starts over. I am getting more and more frustrated that he's bouncing up and down with his numbers. He has missed A LOT of school. Thanks to his 504 and wonderful wonderful teachers, that isn't as much of a situation as it could be in other districts.
He was diagnosed last year when he was 12. Now he's going through puberty and that throws off all the numbers. Insulin resistance seems to be the name of the game. I just feel like I'm fighting a losing battle. I want to be able to go back to work without constantly checking my cell phone to see if the nurse has called because they can't get his numbers under 600. Or that they can't bring his number up over 60, no matter what he drinks or eats. The nurse follows the dr orders to a t. She works with me closely. Yet, I feel ... unable to help him. You can see in his face how much this is taking out of him. He's very social, he's very good at school.
I don't really have a question, more looking to see if anyone else is going through this as well.
Oh, us too!!! Mine was diagnosed just over a year ago just before she turned 11. She's 12 now. I think her teachers are scared of her because every time she looks pale they send her to the office and make her call me at work. I know its awful, but she still had a cough today so I just left her home because I didn't want 6 phone calls from the nurse.
Part of your frustration has to be the nurse. Just ignore any lack of understanding or condemnation you get from him/her. I'm in nursing school now and am shocked by the outdated and incorrect informaiton taught about diabetes to healthcare workers. So just know that you're right, no matter what is going on.
For the highs caused by illness you might want to speak with your doctor about adjusting your son's correction factor. And when he's ill your son will probably have to take extra shots to keep glucose levels lower. But crazy high blood sugars are sometimes just part of being sick.
I took shots for 25 years and had highs and lows constantly, no matter what I did. But once I started using an insulin pump I immediately had better sugars and it helped me not feel so out of control. That motivated me to test and do better. Plus it's easy to correct a slightly high blood sugar. I still have highs and occasional lows but they're not as severe and I always know what caused them.
Crazy blood sugars are part of life for most teens with diabetes. Do what you can to correct but know that it's par for the course.
Take care and hope your son feels better soon. -Jenna
So, we too are having similar issues with our son who is 11 dx at age 8. Just an example, his sugar was 8.3 (145 ml) at midnite (I check him when I go to bed) and when he woke up this morning he was 16.0 (high 200's). We have asked his doctor about this and he has "dawn phenomenon" which is hard to treat unless using a pump (I have the same thing and use a pump and much easier to deal with).
He eats the same foods all the time as he is very picky yet is sugars are all over the place. He has started pre-puberty and his physician said this will make controlling his sugars difficult during pre/puberty. On the good side, the endocrinologist assured us that high sugars on kids his age don't seem to have a large impact on his health long term. Once he hits 18+ and his sugars stabilize this is what is most important towards long-term complications.
As far as school, we live in Montreal, Quebec CANADA and I have looked into EVERY venue and every person/association that can/should help us and still we have issues with his school. There is NO 504 ADA act here in Canada especially my province so I am on my own.
His school gets MAD and complains to me ALL THE TIME when he misses school due to illness/high blood sugars (due to illness) even complain about missing school for doctors visits. They don't care about his blood sugar at all at school and even give him a hard time when he needs to go to check his sugar and sometimes make him wait until they finish there lesson. The gym teacher a few months ago when they went to the park to go snowshoeing refused to take his meter and his treatment for low blood sugar. I called the school and told them I WILL NOT TOLERATE THIS and the principal agreed and spoke to the gym teacher right away and so far so good.
His school has had MANY social outings this year I had to reject since the school had the kids eat their lunch 1h30minutes early (like at 10:30-11:00am) and since my son is on a regime of 4 shots per day (1 at every meal and one at bedtime) and since I give his shots, he cannot go on the outing as well as have his lunchtime shot 2 hours early (I bring him home for lunch and give him a shot at 1:00pm before heading back to school. His school starts at 9AM).
He is come home after school low a few times and I know that this is how it is with the school system in Quebec and this had made it virtual impossible for me to return to work.
Once he is in high school and more independent, then it should get easier.
Good luck and if you want to chat privately since we have some things in common with our son's, please let me know.
I'm glad that I don't have to do this alone. I don't know how anyone can do this alone. Having people know what you're going through is a major help. Thank you, ladies.
Jenna - Actually, our school nurse is amazing. She calls with any question she has. She's nothing short of wonderful. I have talked to his endo team. I've done everything they said. Adjusted his corrections, adjusted his Lantus, done all of it. We've attacked the highs aggressively. And it doesn't seem to faze his blood sugars or his ketones. We're still at trace to moderate ketones and blood sugars over 600.
Jodi - I can't even imagine the frustration you are going through with the school. I'm not sure how different Canadian schools are in relation to US schools. I have been blessed with this school system. i would have flipped out about the school outings. Are you able to go with them on these trips? I've been told that I'm allowed to go whenever/wherever. In fact, I went to see the Hunger Games with his class last year in the movie theater. I did decide that the trip to Washington, DC, wasn't going to happen though. His school is not giving me any grief. I'm sorry you have to go through this with your schools.
I'm so glad your nurse is great. Sorry if I jumped to conclusions.
Sure you already know this, but just to verify, when sugars are high from illness or stress then adjusting Lantus won't be effective. If his blood sugar is still 600 it means he needs more short acting. When I've been sick I've sometimes taken 3x my normal dose to keep blood sugars below 300. Make sure to update your doctors.
Keytones will happen almost anytime blood sugars are super high. The keytones are a byproduct of the body burning fat and muscle to make glucose, since the glucose in the blood stream isn't making it into the cells. Ketoacidosis isn't likely unless your son can't keep liquids to flush them out. If his 600 glucose readings stick around and he's vomiting, call your doctor so they can give him anti-nausea medicine and maybe an IV to rehydrate.
I spent 6 hours in the ER today with Gabe. I freaked out because I couldn't get the blood sugars below 600 and he has been throwing up. Add this morning's Large ketone reading, and off we went to the ER. They were all set to admit him to the hospital this morning. But once they started him on the IV, the numbers started to drop. Thank god. We were sent home with instructions of only drinking non sweetened liquids if his numbers were over 250. Take NovoLog at 1 unit per 15 carbs with food. And doing corrections every two hours with 1 unit of NovoLog for every 30 over 100. I feel like all I'm doing is pumping insulin into the poor boy. His tests all came back normal. No Acidosis in his blood (phew).
Apparently, there are three things that must be present if you are in DKA.
1. high blood sugars
2. ketones
3. acid in blood
I guess my stress was evident on my face because the fellow was concerned how I was coping with what was going on. I explained that the dropping at the hospital meant to me that there is something going on at home that was keeping it elevated. She was very nice about it though. She told me that from what I explained was going on, I was taking the needed precautions and steps to keep him from DKA. True, he was high with large ketones, but the fact that there wasn't that third component meant that I was doing something right.
Jenna - I don't think you jumped to conclusions. I think that there are so many horror stories about schools and school nurses that we naturally go there in our minds.
Glad to hear your son's sugars came down. I do not think you are overly concerned, especially with ketones, high sugars and vomiting. I would have gone to the ER as well, you did the right thing as 600 is very high.
Diabetes sucks big time especially when it is your child...hang in there :-)
I wonder is Gabe's insulin is fresh. If you give him insulin and it doesn't seem to help but the insulin in the hospital works then perhaps your insulin might be spoiled. Can you open a new vial?
You did great epolly. I'm so glad your son is feeling better.
Hey Terry - In this case I don't think it was the insulin that was ineffective. Because he was vomiting he got dehyrated at the same time his high blood sugars were causing dehyration. What made the difference at the hospital was the IV.
This can happen pretty easily to a type 1 kid with a stomach flu. When a child is sick you're supposed to encourage them to sip regular gatorade or 7UP to bring liquid and fluid into the body without causing vomiting. But I had a couple times as a kid when was so ill I couldn't keep anything down for over 24 hours and ended up at the doctors office. Once I had an IV I was immediately better. Thankfully it's not happened as an adult.