How long do BG's remain high after being high for a few days?

Hi. My son was diagnosed in Jan. 2009 with type 1. He is on N, L, and H two times daily by injection. He has been doing very well up until last week - he started running pretty high a few times a day. Three days ago, he began averaging >300 everytime I tested him despite extra insulin. He had SMALL ketones, but has tested negative since. (giving him lots of water). For example - He was at 150 this am, (which is much better than he had been) 250 at lunch and then 410 at dinner (I did increase his H per sliding scale). I have also reduced his carbs over the past few days. My question is, after BG’s have run high like that for two or three days (no apparent reason - he has been eating normally, a little less active, but feels fine), does it take time for his BG’s to lower? I contacted his dr. yesterday and they just told me as long as no MODERATE or LARGE ketones, just keep doing what I was doing and did not seem real concerned. I am concerned of course. He may be coming out of the honeymoon period too - he has been on very little insulin thus far (of course I am slowly going up on it now). Doc doesn’t see him for another two weeks -HELP
Thank you - any advice is greatly appreciated. (Also his schedule has been off with the holidays but he has not had a diet change).

You likely hit it right on : your boy may have weaned himself of the honeymoon period …keep on testing, drinking lots of water and moderately adding insulin …wonder if the basal insulin increment would suffice ?? ( can you test at 3 am for safety ??) …is he maintaining his weight …maybe difficult to assess ?? His BG , if the Doc confirms, that his honeymoon is over will come down , as he requires more insulin .
Take care MOM Cary; you seem knowledgable .

Dave is correct …order the book if you don’t have this in your library yet : coffee table material …am glad you mentioned this Dave .

Thanks to all - I will order the book right now.
I have been using the “Pink Panther” book,
I guess it is a blessing we were in Orlando FL when he was diagnosed. I did receive wonderful education in 72 hours…here in SC I am afraid persons are not so lucky. I have already learned not to rely much on the docs and that this is a "guessing game"
My little guy is one of the bravest 7 year olds I have ever seen!!

Thanks again.

The “honeymoon period” can be rough, because he is still making some insulin, so he will make more sometimes and less sometimes, until he doesn’t make any more, like me. Hang in there. Just remember, you can’t be perfect with this. You can only do the best you can do. I personally love those two books recommended by Dave. They really help you get the good foundation you need. Most doctors probably can’t help as much as either of these books.

You give him Humalog before each meal? I’m confused when you said two times a day.

no - they have him on a odd regimen - he gets Humalog and Humalin in the am; and Humalog and Lantus in the PM. The past couple of days he has had H at lunch and before bed in addition - trying to get these down. It worked very well for awhile but I am afraid it is getting ready to change. He also has a delayed response to this stuff - I have read onset of H should be 15 minutes the peak and one hr it is gone…it usually takes him an hr before it kicks in!! I guess it is different for everyone. Just checked him and he is down again - much better day today, pray that tomorrow will hold good BG’s all day!! Someone also asked if he was losing weight - no he isn’t - but he isnt gaining either — growing much taller at the same time!!

That is an unusual regiment. Humulin R? How old is your son?

Humalog (not sure which H you mean) tends to start working in about 15 minutes (not peak in 15 minutes) & it’s not gone in one hour. If it was, it wouldn’t do much to help BG. Timing of insulin to peak with food is important & this takes fine tuning because we’re all different.

He could have a delayed response & may need a different brand that acts more quickly for him. Where does he take injections? The abdomen works the fastest.

Agree with the others. Any doctor who’s unconcerned about consistent BG of 200-400 doesn’t have your son’s health as a priority.

I didn’t know people used Regular Insulin anymore. But I know that Humalog can last up to 4 hours, starts working in 15 min like Gerri said. Did you try giving the Humalog earlier before his meals, give it more time to kick in. I was giving it right before meals and having too many highs til I realized I didn’t give it enough time to work. It must be very challenging with a child and I wish you luck!!

Sounds like the end of the honeymoon to me!

When I was first diagnosed with diabetes, I rarely when above 200. Then one day I woke up over 400 and then over the next weeks had to DOUBLE my insulin.

Talk to your doctor about increasing the doses. Also, buy the book Using Insulin and tell your doctor that you want to do CARB counting and get off the sliding scale (and use sensitivity or correction factor instead). It involves a little more math, but this will give you and your son much more flexibility. This is all clearly explained in the book Using Insulin by John Walsh that Dave already suggested.

Hope that it goes well! A big hug to your son! Spending that much time with high blood sugars is exhausting for him.