How do you bring down consistent HIGHs?


My son is 12 yrs. old, has had T1 for 3 yrs. and does well overall with managing his blood sugar and carb counts. I do help him but he usually knows what to do. BUT, I am trying to bring down his A1C number before we see the dr. again in Feb. He is not very active, and I do try to get him to exercise each day, but it doesn't come easily. He plays hockey once a week and so that always helps at that time, but I just don't know how to bring down the highs when an ice rink isn't handy. I use a novolog pen when I have to with a shot in his arm and that does help, but what other ideas do you all have? What activities do your kids do when they are high and need to come down to their target zone? Thank you very much...alll ideas welcome.

My son uses a pump and cgm which allows me to be more aware of the highs, and bolus more often with use of the pump. Both have made a huge difference for us with his numbers and a1c. I also have found when he is in range he feels better and is naturally more active.
I personally have found the pump is the best way to effectively manage his diabetes. He is only three but nonetheless has dealt with a lot of highs since diagnosis.

Not sure if you have a pool handy, but that works very well for my 10 year old son. I also find that when is is just out running around with other kids, it helps to bring down highs (it also makes him tend low, which is something we have to watch careful. I would also take a look at whether you think your basal is exactly right. If he is using Lantus, maybe splitting it into 2 doses (on morning one evening) would help him as well.

I agree with both other people - my 11 year old has had type 1 for 3 years also, and after the first year he started on the Omnipod. It's way easier to correct a high with a touch of a button (at least for my son) than with another injection.
However, if the highs are consistent, then he probably needs more insulin on a consistent basis, either with more basal or a higher I/C ratio. Have you done a basal test? Does your endo have you adjust things without their approval?

Another idea wouldbe to increase his lantus on the days he does not have hockey. If he is less active on certain days, he will require more insulin. You could suggest using the schools workout room or a gym membership to provide exercise on no hockey days as well.
Has he ever considered a pump? A lot of the teens in our support group enjoy the discretion and it is a tremendous help for us parents. My son uses the omnipod also, having the software downloads help to pinpoint changes needed in his daily insulin regimen. You can also run temporary basals so on the nights that he has been active, you aren’t chasing lows.

Thank you all for your ideas and insight. I guess the next thing is to track his highs to find the patterns. That's the hard part though because he doesn't seem to have a pattern at all, no matter what he eats or doesn't eat. I can also change the IC ratios without seeing the dr. but without a pattern I'm afraid of having to deal with lows.
I have a theory that I'm testing out right now....it SEEMS TO ME, that if he goes to bed and has no "insulin on board" (Omnipod's tern), and his number is in a good target zone, (150-200) then he stays more stable and in range throughout the nighttime. I still check him at 2 am each night, but it is less llikely that I have to correct a HIGH or feed him for a low. Has anyone else noticed this to be true? Thanks again :)

ONe more thing...I got this idea just the other day. I have now told him that whenever he is over 200, when it is possible, that he has to jump rope/run in place, etc. for a brief amount of time to help bring it down. He did that last night when his BG was 208 and within a half hour he was 168. :)

just a thought i agree with the nighttime bs being important when my son was on shots if he was over 200 we would give a small amount of novolog say .5 u with his bedtime snack even now on the pump the bedtime bs and bolus is important if he is low we may under bolus and over carb and he wakes up high ussually if he is in the 100's before bed things work out the best but if he is high we correct but have to be careful not to overcorrect ( he has never been low at night but occ. in the 60 or 70's without feeling low in the am ) for activity like you said just going out and playing or walking is good or walking around a store but i would be careful at his age not to encourage activity just to get his bs down to much i know my son resents this sometimes they may know what the right thing to do is but hate to be always told or reminded about their D at this age, jacob is 13, i am alway "busy" behind the sceenes trying to work his numbers right and involve him but try to make it seem like it is just part of our routine he will have his whole adult days to deal with this for know i try to still be the master planner so to speak! has your son considered a pump it is way easier to add a little esp. for grazing. it took my son a while and finally changed his mind afer seeing the omnipod on utube their are advantages to both but it must be his choice good luck! amy

hello i just saw on your main page you are omnipoders! temp basals are great for consitent highs we tend to have to do this after a pod change, have you had issues with this? i think it has to do with insulin absorptions issues i didnt to a temp basal yest because he was low at pod change then he snacked, bolused and went outside even did his pull up routine and he was 300 at dinner grrrrrhhh i try to give him a small bolus .5 is at a pod change then a temp basal .15-.25% depending on what his number was at pod change and based on what he will be doing i do if for 1 1/2 hours to start then maybe another hour if need be so many variables it gets overwhelming sometimes! hang in there we all have alot to learn from eachother just talking about their care to others that can relate is a big help. amy