I know we all talk to our Endos when we have questions. But I wish there was someone…other than them…that I could send my son’s numbers to on an every few days basis and they review it and tell me what changes to make to his numbers. Maybe a computer program that you log the numbers into and then it just spits out the new ratios?
He had 5 great days in a row and I was so happy that I had “figured” it out right and now he is on a roller coaster ride. I sent the numbers to his Endo…and they will help… but want some other way to figure this all out. I am no expert and I am in charge of my son’s life??? Somedays that feels so overwhelming. I just want to make everything right for him.
It is impossible to calculate the ratios from the numbers. The diary is full of false data: miscalculated carbs, misjudged activity, flaws in blood glucose measurement, wrong basal insulin or dosage, the body reponds sometimes differently to the same treatment and so forth.
This community is full of experts and we will help you or at least we can try. You can register on my Glucosurfer.org project. There you can manage your son’s diary. This diary can be shared with the Tu community. You just have to create a share on your Glucosurfer diary. This share is a link you can put into your discussions. With this link all members of TuDiabetes can visit the diary and hopefully the following discussion will give you some ideas about possible improvements.
OMG…thank you!!! I love this site but didn’t know that exisited!!! He has only been diagnosed since November and at first it was all “new” and that was what kept me going. Now…after reading about Jesse… I am in a slump where I feel overwhelmed with the responsibility. He is 15 and takes a lot of the responsibility on himself…he is learning along side of me…but right now…it is ultimately my responsibility. Thank you! I will check it out right now.
Hey, Katsz,
This is something you and your son are going to have to learn to do for yourselves. As Holger say, there is no formula that works every time, all the time. It’s part science, yes, but also part art.
Get a copy of ‘Think like a Pancreas’ by Gary Scheiner. You can find a link on this site or go to Amazon. Read it with your son or have him read it too, if he’s old enough.
Use the numbers to spot trends keeping two facts in mind - food raises BG faster than Insulin brings it down. You should also know the peak time of your son’s insulin - that is, how long after injection does it start to lose its effectiveness. For my Novolog it’s two hours. Therefore, it’s important when making decisions to look at what was happening two hours before an event and consider what things may be like two hours after an event (injecting or eating.) Also to test two hours after an injection to see the effects and make adjustments quickly.
For instance, if BG is 200 at 6:00 pm - what was happening at 4:00 pm? Have a snack, play soccer, do homework? After giving an injection, check again two hours later and ask what did we do right or what did we do wrong?
Remember also that insulin is not the only thing you can adjust - food and activity (including sleep) are two other important factors.
Sounds complicated, but thousands of us have got the hang of it. it’s a juggling act. We all break a lot of dishes. Just keep juggling.
And get the book.
Terry
I am about 1/2 way done reading “Think Like a Pancreas”… love it so far. He had 5 days in a row last week where he was never lower than 70 or higher than 199. I color code his chart for lows and highs. All these number are, however, the readings right before meals/snack. So …he might have been higher inbetween.
I think what is throwing him off right now is w/the good weather he is riding his bike… it took him on a low and then he corrected and has been bouncing ever since.
I just looked into that Glucosurfer thing. Sounds great but I don’t have web service on my phone but my son’s does and will see if we can work it from his which would be best anyway.
Here is yesterday 211 night before 158 breakfast 138 lunch 183after school snack 134 dinner 292 bedtime
11pm 102 2am 124 6:30am 157 ( We correct anything over 120 and then bolus the carbs if he eats)
Like I said…the whole week before was great! but Yesterday just was a mess!!! I woke him up to check at the 11pm and 2am because the drop from the 292 freaked me out! I assume the increas from 2 am to the morning is the Dawn Phonom?
I see that we have to learn it. I assume some of it can be because he is still in the honeymoon phase?
He will be going on the Omnipod by the end of this month or next month.
Thank you for your input…I do appreciate all I can get.
Hi Katsz,
John Walsh’s Using Insulin is another excellent resource.
Sherri Colbert’s Diabetic Athlete provides a lot of info on making corrections related to physical activity. It includes everything from walking and gardening, to cycling, kayaking, tae kwon do, skiing, etc. I prefer her 2001 edition, but the more recent 2009 edition is quite good.
And to have 5 great days in a row is awesome! Study those days. What made them great? What did your son eat, how did he dose his insulin, when did he eat what, what kinds of activities did he do? Etc. And study the bad, rollercoaster days. Same questions apply. It’s all about looking for patterns, so you can predict how his body will respond in the future to various activities/events.
And it’s like riding a bull, except they don’t ring the bell after 8 seconds. At least I haven’t heard a bell in the last 12+ years I’ve been on this ride.
Good luck and best wishes, Mike
Frankly I would discourage you from turning to an on-line community for specific medical advice. You can ask people’s opinions, but don’t ask medical advice. It sounds like what you really want is a competent RN, CDE or PA who you can call as needed and get this type of immediate feedback. Part of your challenge is putting together a good diabetes team and that goes beyond just your endo, whose time is limited. If there is a CDE assocaited with your endo, you can perhaps talk with them. Otherwise, a good approach is to find a good diabetes center and make some connections with the RN’s and CDEs there. A list for your area can be found at http://hearttruthdelaware.org/community-resource-guide/kent-county-…. And it appears that Bayhealth has a Diabetes Care Center with an education program and CDE’s, their number is 744-7135.
I was diagnosed in June, and for the first six months I called every time I needed to make a little adjustment to my basal, if my sugars ran over 200 at all, if I snezed and got dizzy. I called about everything… just after my first 6 months, I moved to a new city, with a new endo, and until she ( a diabetic herself) told me I could do some of these things on my own, I kept freaking out. She let me know what was a reasonable change for me to make ( ie: a unit on my long-acting insulin, or a small difference in my ratios) and when to call her (if I was over 500, if I was noticing a pattern and wasn’t sure how to change my insulin doses, if I was testing positive for keytones)
Remember that because your son is 15, his horomones are going crazy, and they will have a direct effect on his bloodsugar. Remember that you and your son are both dealing with something that is very hard, and many people do a very, very poor job at. By asking for help you are taking better care than most diabetics out there.
I mytself am 18, and I took on Diabetes on my own. I’m not sure, but if your son is anything like I was at 15, the more you let him help make these decisions the better he will feel about them. The more he knows about managing this himself, the better he will do in the long-run, the better choices he will make when he is at school or out with friends…Make sure this is a learning experiance for the both of you!
I think the best question to ask your Son’s endo is what is normal for a kid his age? What is a reasonable change for you to make on your own?
Good luck. Remember you are still new at this and there is a learning curve.
Rock on!
They have been letting us make the changes. I can email or call when I want but today’s email wasn’t ever answered! I could call though and that usually works w/in a few minutes. We were doing it all and doing well…for the 5 days I mentioned. The thing is now he is more active. I thought that would cause lows but it seems to cause rebound more than lows.
He does all of his shots…He won’t even let me try to give one anymore! He does his school dose on his own and it is a mix of me and him when we figure out dinner and breakfast. I keep the log book though. A. his writing is hard to read and B. He kept forgetting to put it. He and I discuss what is happening and what we thing we should change.
I guess I am doing ok… it is just the responsibilites of it all gets scary for me at times…especially when we can’t figure out what’s making him go on the ups and downs.
I definitely understand. We all have good weeks and bad weeks…
Exercise is compex. Some people’s BG just goes up when they exercise, I have experianced an initial spike, followed by significantly lower sugar…
I would recommend the Diabetic Athelete’s Handbook
It helped me with my BG a lot when I started exercising…
Good to hear your son is being so proactive… Let him know we all are here to support him if he has any questions or concerns…
Stay strong!
Hi Katsz-
I don’t know if anyone else has mentioned this (i didn’t read all the other comments), but another thing to keep in mind, and to help you maintain perspective, is that hormones can also influence blood sugar levels. You can be having perfect readings for days on end, and then all of the sudden something crazy happens because of hormones. It’s especially noticeable in women, but as your son is a teenager, and probably still growing, it’s probably influencing his readings occasionally.
And also, remember, one or two high or low blood sugars most likely won’t do any permanent damage, it’s the overall trends that you need to worry about, and it sounds like you guys are doing a great job at that!
Good luck and I’m glad you’ve found this community! It’s been a great support for me, and we all learn so much from each other! Thanks for your contributions!
He is still biking everyday after school and today he had a pretty good day over all. 157,189,146,101,148 Not perfect but the strange thing is we haven’t changed his ratios since before when things got bad?? They have been the same since the five good days…3 bad days and now today. Maybe his body is adjusting to the exercise??? I feel best when he is between 70 and 140. So I don’t consider today a “good” day but a lot better than when he was hanging in the 200’s.
Great suggestion. In addition to Sheri Colberg’s Diabetic Athletes Handbook, she has lots of information on-line at www.shericolberg.com. And as Maia notes, blood sugar behavior with exercise can be complicated and very individualistic. The forces that drive blood sugars up and down are far more complex than just what you eat. And the time frames also complicate matters. For some people exercise can improve insulin sensitivity for literally days.
Thank you. It all does get complicated. I want a cgm for him if he can. Last night he went from a 148 and woke at 190! So… I know that it could have been 3 things…(or more)
- Dawn phonom.
- needs higher Lantus
- he went low and it was that rebound thing
Yikes…so I am going to see if it happens again tonight. If it does…then raise lantus slightly from 20 to 22. I have been putting his numbers up on my status. If you ever have any time to look and tell me what you think…I’d love it.
I will tell you that the Somogyi effect (the rebound thing) is thought to be rare, most hypo aware diabetics (like a child) awaken with a hypo, and it is now thought to be fairly uncommon and usually results in an strong counterregulatory response and blood sugars more like 300s.
Make basal adjustments only after making observations over a time period like a week, if you consistently have elevated fasting levels and high morning numbers, then make changes. Life is awash with aliens always affecting a diabetics blood sugar, and many of these variations must be considered noise. Only with accumulated knowledge can you make confident changes, otherwise you will spend your life chasing highs and treating lows.
when you say he does all his own shots and his school dose please make sure he is really giving his insulin. He is a teenager and part of his life is fitting in with his peers.
Hello Katsz. My daughter started on insulin Oct. 2009 and on the OmniPod pump Jan. 8, 2010. I did read where your son will be starting on the pod soon. The Pod makes diabetes easier to manage, I promise.
One way to know if a meal bolus is working is to check 2 hours after eating. One way to know if long acting insulin is working is to check every hour after 2 hours when no food is being consumed.
I will look at your status and see what I think. Remember I’m only a mom with little experience.
Thank you!! Glad to hear you are liking the pod. He has another pod class on the 16th then soon after he will be getting his. I know he will fell better on it because he doesn’t like giving shots in public places.
Have you ever checked your Bgs w/your child’s meter? I have. Today I am worried. I woke up at 111 and had two sugary coffee’s and now I am 158! Ok…well…I am not going to worry about that yet.
I think we do err on changing things to fast and then chasing our tail. The “aliens” analogy really makes sense. Thank you.
He does… I am usually right there with him at home and the school nurse when he is there. Right now…this is all so new. I am hoping he keeps doing it so well after he has his pump.