BG all over the Place. Are we the only ones

Hi we are Mike and Amy. Our daughter name is Danielle she is 8 years old. She was diagnosed Oct. 5th 2009. It has been three years,. She currently has the One touch ping and dexcom. I here all these stories that the target range is suppose to be between 80 and 120. During the night Danielle stays usually above 200 because we have seen her plummet in the middle of the night. We try to use the pink panther book guidlines for nighttime. Here is my question. Lets say in the morning she is 160bg and we feed her 50 carbs with 3 units of insulin. She will sometimes go up over 300 at times and with the same carbs she may go to 130 after two hours. I can go on and on about the crazy numbers. What can we do to help control her numbers better. Her A1C was 8.5 last time. Any information will be helpful. Thank you. Also any books that you would recommend.

Well my son was diagnosed at 8, and his target range was 80-180, so I'm surprised you would have such a limited target. Even non-diabetic people sometimes can go over 120. Have you tried experimenting with different foods for breakfast? My son stopped eating cereal since he shot up so fast and so high.

Beyond that, how much basal testing have you done? I love the book "Think Like a Pancreas" by Gary Scheiner. It helped us determine my son's basal rates much better than trying to fit a model based on his age or weight or anything else. We found that his blood sugar actually was shooting up without even eating breakfast in the morning, so we actually raised his basal about an hour before he wakes up to help with the after breakfast highs. We also found that he needs less basal between 2 and 6 in the morning - and when we adjusted that he stopped dropping in the night. But we did this over time, and with the methods in that book. Don't know if that helps but it's what worked for us! Well - as much as anything else "works!"

My daughter is 8 and her range is 80 - 180 - I think your range is too tight for one thing. We have been doing this for 2 years and I still keep a written log which just confirms that some days are diamond and some days are stone. She can eat the same thing two days in a row and have different readings.

We find with our daughter if she is around 180 - 200 when she goes to bed she will usually awake around 100 - 120 in the AM - she is very small - only weighs 48lbs - her basal rate at night is .035 - on the pump. We have completely changed our diets since her diagnosis to food that have a lower propensity to cause spikes. She loves PAncakes and waffles and New Hope Mills out of New York makes a great low carb pancake waffle mix we buy by the case. Usually try to give her insulin 20 minutes before she eats to head off the spike as there will always be some.

We usually check her 2 hours after she eats because there will alway be a little spike after eating.

Dr. Bernstein - The Diabetes Solution - Controlling Blood Sugars is a good book as well as the other one that was mentioned - read these two and you will want to keep them around for a reference too.

It is always a challenge and the more info we can all share and pass along the better for all us struggling parents.

God Bless and I hope this helps a little

Crazy numbers - yes, no fun - I always wonder if it's just me. We go to diabetic support groups and events and when someone gets up and says "I can't believe my child was over 200 two weeks ago" I want to punch them. I just say "Yeah, Jack was 400 when I left to come here" and then I get stares like I'm the bad Mom. However, I have enough support from other people who say they have the same experiences.

My son was diagnosed at one and is now 3 1/2 (our kids were diagnosed around the same date - Jack was 9/2009) and I never feel like I have control. We manage the blood sugar, but do not control it by any means. I have fed him the exact same things on two different days and get two completely different results.

The only book that has really helped me is Think Like A Pancreas. The suggestions for food and insulin are what has worked for us. Jack's target BG is 120. I also run Jack 100-160 during the day and 160-240 at night, and his A1C has always been in the 7's. However, my child is run a little higher because of his age and inability to communicate. The main thing the endo tells me is not to run him too low, and if he goes low or high to not let him hang out there for very long.

The only thing that makes me feel comfortable in figuring out what's going on with his BG is with the Dexcom, which you already have. Hopefully that in and of itself makes life easier.

Mornings are terrible - I mean, seriously what are you going to do - you have a good starting point (no residual correction insulin), but human growth hormone spikes between 3AM and 11AM. So how do you know if it's the food, if it's timing on a pre-bolus that got away before insulin hit, HGH, or an early morning low which is causing an ill timed liver sugar release? Or if he's just getting sick AGAIN? The only thing that helps us in the morning is yogurt - we get a soy yogurt which has a low sugar content, which he eats every day along with other items - and somehow that helps keep him steadier.

Hi Mike and Amy. My son is 10 and was diagnosed 8 years ago. He is on the Omnipod. One of the nice things about a pump is that you can change the basal rates at different times of the day. It sounds like Danielle's basal rate at night might be too high if she is dropping that much in the middle of the night. Just as an example, my son's basal rates are 4am-10am: 0.45u, 10am-3pm: 0.35u, 3pm-7pm: 0.25u, 7pm-10pm: 0.60u, 10pm-4am: 0.25u. The book Pumping Insulin by John Walsh was a big help to us in figuring out how to get the most out of the pump.

Also, mornings/breakfast are probably one of the most difficult times for us. My son has a breakfast ratio of 16:1 whereas he is 34:1 for lunch and 44:1 at dinner. We found some foods are impossible to handle (cereal) so we avoid them. In this instance, the saying "a carb is a carb, etc" is definitely not true. Maybe find a breakfast that works for her and try sticking with it for a while just to see if you find more consistency, then try varying the carbs?

Also, just as a point of reference, similar to you, we see numbers as high as 400 and as low as 40 at least every week, but we've always had an A1C in the 7's. Things are going to happen that we can't predict or control. We're not perfect, we can't explain a lot of what happens, but we just keep trying. That's really all you can do. Good luck. Allison

I am a believer in the lower carbs and finding alternatives. My daughter has been Diabetic now for 2 years and her A1c's have always been in the mid to high 6's. We haven't broke the 7 barrier yet. We haven't experienced a lot of lows either. Kids need carbs so we didn't go crazy but follow a lot of Bernstein's recommendations in his book. I agree with Allie 100% on the Basal - it is a moving target as they grow but sounds like she really has it dialed in.

My daugther was diagnosed at age 2 and she's almost 5. Our numbers are all over the place too and we fight highs more than lows. I feel like the bad parent too because I know so few other parents of type 1 kids and all I read about is well controlled kids We use Levemir and the pump. I know it sounds strange but my Mikki has 2 brothers and her cannuals always kinked when on the pump alone so we use a long lasting insulin so that she can take off the pump when she's horsing around, and we just bolus for food. I have more peace of mind this way. Just want you to know you aren't alone. I will need to pick up the books recommended. I often thought if Mikki was my only child maybe I'd be more on top of things, don't know...

When we were all over the place, I took a step back and tried to start "new" with his settings.
Nightitme Lows:
Is she dropping low at night after a correction earlier?
Does she have a bedtime snack, and if so, what?
IF she's not having a snack and not being corrected I would lower her basal for the earlier portion of the night, and have a higher basal to start combat the early morning rise

Welcome to my enemy. Ive started giving him the same of 3 exact breakfasts and tried bolusing different each time for various results. Our highest basal is 7a-11a, and there was a time the Supoer Bolus combatted any breakfast spike. Im back to trying that again.

Dual Wave-Extended-Square Wave Bolus:
What ever you call it, its your friend. Bascially anything my son eats is "kids food" and would qualify the neef for an extended bolus. I bump the insulin dose a few carbs based on what he's eating and split is 50% upfront and 50% over 3.5 hrs. Works like a charm for the tricky resturant foods.

This is so frustrating because I couldnt test any of this without fear until we got a cgms. Now I can feel comfortable changing things to see what works and get the inbetween info too

Finally, I HATE that I cant "control" diabetes...and literally wanted to punch the CDE everytime she said it. Alas, she is right and Im still coming to terms with it :( Although knowing that every number helps understand the next number is easier than thinking every bad number equals failure

We have found with our son who is now 9 and has been on the pump 3 years that as parents we can forget that the kids are growing- weight change height changes. All these hormone changes should be considered when settIng basal rates. Agree breakfast sets the tone for the day.

"Dr. Bernstein - The Diabetes Solution - Controlling Blood Sugars is a good book as well as the other one that was mentioned - read these two and you will want to keep them around for a reference too.
It is always a challenge and the more info we can all share and pass along the better for all us struggling parents.
God Bless and I hope this helps a little"

Hi, Since someone already mentioned Dr. Bernstein I wanted to let you know our experience. My daughter is coming up on her 1st year anniversary. Because we follow Bernstein's low-carb regimen, her A1C has been a consistent 5.3. The low-carb way just works. She is not on a pump and does fine with MDI. She is 10yo. I know this is not for everyone, but it works. Her range is 80-120 and she pretty much stays there unless there is a wild card like a restaurant meal. It also helps that we love to cook......yesterday we made our own egg-nog with DaVinci was awesome!!

Definitely get Bernstein's book......if just to take a peek at a different way of doing me there is another way. I know it is controversial.....but that is all it is. The ADA folks don't want to admit that type 1s CAN have control!

God Bless, and good luck!