Tonight we went to the movies. My hubby and son went to the consession stand while me and younger son went to save our seats. My son had picked a box of sweet tarts! 11 servings=142 carbs! He needed a 10 to cover so he did. However he was already high before and didn’t add in the correction. By the time it was dinner he was 336! Does candy since it is pure sugar need additonal units…I know he should have been somewhat high because we didn’t do the correction but that would have only been 12 units instead of 10. Someone please explain the difference in the types of carbs. Normally he is supposed to stay at under 75 carbs per meal. We stick with that 98% of the time. This was just a special case where I didn’t have the heart to take it away. We were afraid to go more than 10 units so that is why we didn’t correct. Yikes!! He really soared! Not going to do that ever…ever again.
Pure sugar does not necessarily require more coverage - but you have to take into account that nothing is attached to the sugar in sweet tarts -as in fat - such as would be attached to pizza, for example, that may effect the way you bolus (extended or square wave bolus). So, no - not necessarily additional units, but the way you bolus (especially if he has a pump and can do an extended bolus as one may do with pizza or other high fat containing foods - some even use extended boluses to cover high carb foods such as pasta - or Sweet Tarts in this case - everyone reacts differently). Maybe try - a serving or two of sweet tarts - not the whole box - more reasonable, don’t have to take the box away, but he gets to have a “treat” which you can reasonably cover for. Use this ias a learning experience - not a negative experience. Your son can see now how foods such as sweet tarts (especially in large quantities) affect his BG. Always a teachable moment involved.
Ok… yes. Not a mistake we want to make again. He is now down to 205 after 3 more hrs. So we corrected again with no food snack. We will check again in 3 hrs and correct if needed then do his nighttime Lantis. He still thinks that anything that doesn’t need a correction is good and he panics if he is “good” like at 100 or 80ish. I keep telling him the Doc says that 70-120 is good and not to panic at those numbers. The lowest he has ever gotten is 50 and the highest…well when first diagnosed…was over 600. YIKES! Thank you for your reply. He has only been diagnosed since Nov. All the advice we can get helps. (ecept the advice of a neighbor who said that Apple Cyder Vinegar could cure him.)
Wouldn’t that make him higher? Doesn’t he need it before the meal? We were told before he eats is best. Not sure about how this extended bolus works. He will be going to his first pump class in March and could have a pump as soon as April. He wants the Omnipod.
Before going any further with the advice or listening to the advice I suggest you read Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin.
The fact is that there is no way to cover the amount of sugar your son ingested in that time with external insulin. The insulin takes time to get in the blood and even 10 units may have looked like it was covering, but the outcome may have been unmanageable, just like the high.
Next time get him food that will raise the BG at the same rate that the insulin will lower BG. There are candies that are like regular food, such as a Snickers bar that can be balanced easily with an I:C to cover the carbs.
Definitely a great reference.
I don’t want to advise you to do anyhthing I am in no means an expert - just saying what has worked with me. YMMV.
He is down to a 160 now. He corrected and did his lantis and is going to bed. Hopefully he will be down to a better number tomorrow. Lesson well learned. He wants to do something big for his 100 days diagonsed anniverary like a Milkshake or Donut! He is on day 91 now. I told him that tonight was the “celebration”…he still wants to do someting that he has to dose big…Does anyone else “celebrate” in a “high” way?
i have kinda wondered this myself too. Our diabetes educators have told me that a carb is a carb is a carb (I have checked this a few times) my husband (who doesn’t carb count) disagrees and if he is high and did have candy or chocolate milk at the earlier meal will blame the high on that (but he is not always high after these things nor is he only high after having these things). Though if he is having candy or something of that nature I try to have him eat something with it as I know it will go in faster…
that being said he was 4.8 before supper and had 65 carbs worth of candy with his meal (and way more carbs total then normal) plus the right amount to cover all the carbs and was 13 at bedtime.
Thank you. I think we made it though this one. Maybe it is good there is a “honeymoon” period in the beginning when you are learning such things.
Another good book is Using Insulin by John Walsh. Really is hard to dose for fast acting sugar. I save those to correct lows:)
Yep, his injections need to be taken before meals.
Check out Jenny’s site http://www.bloodsugar101.com.
I was talking to someone else about this somewhere else in this site . I know some educators say a carb is a carb but from my experience I dont see that. Check this article out below that explains fast acting carbs vs slow acting carbs and the type of effects. I have tested a lot of carbs since I like to bike for long distances and i need different carbs for different times of the workout. I am a type 2 but I have an issue with going low very quickly without insulin. I can go from 200 down to 65 in 20 minutes by just biking. So i have tested carbs to see how fast they can bring me up in a work out and how long they can last. Candy will bring me up like no one’s business while bread will bring it slow but last longer. Same carb count. So check the article below about the different carbs and the glycimic index.
My son loves to bike too. He hasn’t biked since he was diagnosed…well not like he did before. He wants to start biking again once the weather gets nice out again…we are currently under a blanket of snow. So far we can tell that exercise brings him low pretty quickly. Can you give us any pointers on what you have learned about biking and Diabetes. He will have a pump this Spring…hopefully. What should he bring w/ him to bike? What should he eat before biking…can I let him bike alone??? Spring will be here before I know it and the idea of him going for his usual 6+ mile bike rides scares me to death. Pointers please???
Maybe not a “high” way =- but I will work a milkshake or ice cream into the overall meal plan for the day so I can have it and not deprive myself. Moderation is the key. Planning is important. Maybe have him go play some basketball or run around a bit after. This helps me from spiking high after a treat.
A carb is a carb but the problem is that for huge amounts of candies we need a type of precision that is unrealistic to achieve.
- the exact carbohydrate factor must be known for this hour of the day.
If you assume that your factor is 15 and the real factor is 12:
142 carbs / 15 = 9.46 = 9
142 carbs / 12 = 11.83 = 12
The difference would be 12-9 = 3 units => 90 mg/dl above your target (depending on your insulin sensitivity).
That is the reason why high numbers of carbs are not recommended: a slightly wrong factor can scale up to a huge error.
- it is hard to determine the speed of sweets. Some may have simple sugar, some may have pure dextrose. With an external injection you need to wait until the insulin is active. There is a high risk that you will not win this race between digestion and insulin activity. If the insulin came to slow you will spike. If it comes to fast you will go low. Furthermore a huge dosage of insulin is absorbed slower and acts longer than a small dosage.
Because of these reasons I do not eat very fast acting carbs (only to treat a low). It needs some bad experiences to realize that it is not worth the aftermath: the spike, the corrections, the reduced sleep to stay up at night etc.
Great! Your number (1) is the corollary to the famous “law of small numbers,” and it would probably be appropriate to call it the “law of large numbers.” It is my understanding that also with higher blood sugar levels and higher insulin levels, “insulin resistance” sets in, not permantently, but in a transient manner. Perhaps others more experienced may chime in, but often, if you are fairly high > 300 mg/dl, you may require more insulin than expected to correct, you are in essence insulin resistance. Further, higher doses of insulin may absorb slower, although 10 units is still a modest dose.
Chocolate candy is easier to calculate. And I’m talking 2 or 3 pieces, not a box. LOL
Life lessons…Part 2! We went skiing…he loved it. Seemed fine the whole time. The low came that night at 1:30. He went down to a 60 and it took the 15 rule twice to get him to 102…but then he woke up at 166! so…over corrected when he was low.
Wow…you really do have to be a scientist to do this right.
The 15/15 rule doesn’t work for everyone, as you found out:) Depending on your son’s carb sensitivity & weight, this can be too much. I wish people were given better advice for correcting lows because for many it ends up being a over correction. Other than everyone being different regarding their reaction to glucose, it can take up to an hour to see the effect, so people keep taking glucose after 15 minutes & end up high.
That is exactly what happened. He has been running high all day today too. Up to 203 buy snack time. Then…he forgot to correct and had some Valentines Candy for snack and only coverd it. These few days haven’t been good to him for sure! Hopefully now that they might…might be going back to school and this snow break is over things will get back to normal. He had Ferro Rochere (SP) chocolates for Valentines…way easier to calculate at 3 pieces/16 carbs. I only go him a small box to ration off.
We do still panic when he gets low. Do you ever get more relaxed about it and how do you not over carb it?