Last week Rory had issues with consistently lower than normal readings. It started late Sunday and continued through the week. He would eat his usual meals and in sometimes less than 2 hours drop down to the 60s, and wasn’t repsonding very well to the usual carbs that would bring him back up. For instance on Tues. my parents were here helping out while I was completing a certification course,he was 82 at lunch, 1 hour after lunch before his nap he was 72, we told my parents to give some grapes and goldfish, 30 mins. later he was 66, they gave a few more goldfish, he went up to 77 in another half hour, then to 76 half hour from that, About an hour after that he was 59, he apple slices and went up to 66 and was up to 96 by dinner time around 4:30. These were all usually things that would send him up quickly before. I felt bad for my parents because they are nervous enough as it is with learning to do his pump and then this happens. This kind of trend continued and yet he would be above 200 during the night. We wasn’t any more active than usual and he was eating all the same types of foods as usual. I decreased his basals across the board and changed his carb. factor. I spoke with the nurse and we eventually had him changed to 1/25 when he had been 1/9 which is what he had been for 2 months. I spoke with the endo doc on call Thurs. night when things weren’t really going any better, I didn’t even cover him at dinner and he was 93 before and then went to 70-79-58 respectively within 2 hours even though he was getting uncovered carbs. She instructed me to decrease his basals more bringing his avg. total insulin down by almost half because over this time his basal rates were becoming over 50% of his daily total. The only unusual thing he had going on was a brief bout of diarrhea on Tues and Wed. The doc did mention that exercise can have a delayed lowering effect if he had been active. But he wasn’t doing anything more than usual. My husband and I were totally baffled by this since he had been running fairly well at his previous settings for almost 2 months.
Now after making these changes and having him run at the new lower settings since Thurs. he seems to be trending back. Yesterday and today his was pretty high 2 hours after his breakfast and other meals. Today he was 128 before breakfast and ate his usual stuff and was covered based on the new setting made on Thurs. that seemed to work fine over the weekend, but today he was 390 two hours later! I changed his ratio to 1/20 and will see how this will work at lunch. He does have an appointment this Thurs. and hopefully they can give me a little insight as to what may have been going on. The nurse on Wed. didn’t seem to think the diarrhea would have had anything to do with it. But I was thinking maybe it affected how well he was absorbing things, and of course the juice we were giving him to bring his BGs up weren’t helping with the diarrhea either.
Just another frustrating moment in the daily challenges with this disease. I just feel bad that my parents were a nervous wreck and my husband and I were doing the best we could to advise them by phone until I could get home.
Right now I am dealing with highs with my 18 month old son and he doesn’t use the pump yet. I am sorry I can’t be of any help. Hope you find out whats going on at the endo. I wouldn’t be suprized if the diarrhea did have something to do with it.
Hi Natalie,
We just went through the same thing. My son is 10 and was diagnosed 8 years ago. We’ve been pumping for 5 years now. We went through this week long fight to keep his blood sugars up this past month. Since it’s baseball season and he’s been unusually active we decided that exercise was the cause of his lows and created a 2nd basal pattern.
The following week we were battling highs so we went back to the old pattern. Nothing had changed. The exercise was the same, the carb count was the same, everything was the same from the previous week. No illnesses, nothing.
All we can do right now is shake our head. It’s this stupid disease and there is no rhyme or reason to it.
I know this doesn’t give you any answers but you can guarantee it’s happening to a lot of us.
This is scary!! Ella has had some unexplainable lows also. Not as bad as your son, but too many lows in a row for last weeks totals. Our endo asked us if she was any more active than usual. And no only because its been cold and cartoons rule right now. I lowered her to 0.5 units for every 15 carbs, but even then I’ve been giving her 0.5 if she eats 35 carbs and starts at 132, for example. She was very high last night 360 at 11pm. I let her sleep and she woke at 106. This is good. The last six mornings have been 60 or below with high night readings. My guess is toddlers have growth spurts, and the blood sugars react to that. Good luck and God Bless.
Thanks. It is so frustrating. I am the type of person that wants to know the reason for why something is happening and then I can feel better prepared if it happens again. But that doesn’t always happen with this disease. The nurse had said “let’s not worry about the reason why and just focus on fixing the problem” That kind of aggravated me but I realize there isn’t always a clear cut answer. The doc said they call it the “Miracle of Summer” since kids are outside and more active and their insulin needs may decrease. I understand that, but when he really isn’t any more active than usual it gets confusing. I really think the diarrhea he had must have been the issue. Now that we have decreased everything he is swinging back the other way. I am so glad he had his appointment this Thurs. and hopefully we can get him straightened out again with his settings. I feel so bad for the little guy when one minute he is over 300 and then in another he is 58, his poor little body, he must feel so crappy when that happens.
Well the docs determined that if he was going low because of the diarrhea and not absorbing his food well than the basals were set too high. So now we are trying to do some delays and get his settings figured out…again. It makes sense, in the end if we were just letting him eat and not giving him the bolus and he was still going low, than that would be the basal causing that.
That being the case he it seems he will need a much higher carb factor at breakfast to keep him under control. With the changes we had made he was spiking up to close to 400 2-3 hours after breakfast, after eating his usual foods. And for him when he goes high like that he just turns into an aggressive, crazy, irritable child. It is very frustrating to manage. I feel bad when I can tell he is acting out because he doesn’t feel right, but others may not understand that. His doc said ideally he should be less than 200 at that time.I usually give the correction the pump will allow and wait until he is in a more normal range for lunch.
The breakfast delay is always easier to do. But so far it seems that basal is where it should be , and it is less than where we had him before the diarrhea. Now just to get the rest of the day figured out. His night time one seems to be good also, I think what he eats at dinner affects those numbers most of the time. But things are starting to settle back down.
And we will have to wait until June to try the trial with the CGM, the office just got new sensors and the staff has to complete their training on them first.
Sorry you have had a rough week. Basically, if I see that corrections don’t bring her up and keep her up, I assume her basals are pulling her down. This can happen even on recently tested basals. Could be due to more exercise, anything really. So the second time she drops on a correction, I decrease her basals, using the temp basal feature, three hours, maybe four. I will then watch the next day to see if this is a permanent or temporary change. Stomach bugs are a totally different matter, very dangerous because they may not absorb the carbs and you may not be able to keep BS up. Sounds like that is what was happening. You need to call the endo in this instance. We dealt with a stomach bug only once, shortly after diagnosis, she was in her honeymoon and we did not have a problem. The same can be done for highs. If the second high of the evening does not respond to correction you can assume he needs more insulin for whatever reason. Just try the temp plus basal for two hours until the next blood sugar check and you will see if he moves down a little. If you do increase the basals at night, be careful and do blood sugar checks. I think you are absolutely right about the diarrhea; not sure why the nurse thinks it would have no effect on the BGs. Nurse probably does not have much experience. Since he was stable for two months, I’m assuming it is time for a growth spurt; hence higher numbers at night. Someone once told me to stop analyzing so much; if high, give insulin; if low, give carbs, LOL. If continuously low, reduce basals; if continuously high, increase. You handled everything as well as you could have and it is great your parents are helping. You did pull through!
