My son is T1 Diagnosed nearly two years ago

Since the beginning we didn’t find it all that difficult to regulate his BS. His insulin need were low. Up until recently, I mean the last month, he was doing well on 9 Units of Novamix in the morning and 4/5 units of novamix at night. In the couple of weeks we have put him up a unit in the morning and one at night and giving him a unit of rapid in the day. But his BS is coming out from 12-28 at almost every reading. He isn’t eating more, he is excercising the same. Even days when he eats less his BS is still in the 20’s. I feel as if I have lost all control. I thought I had a handle on it but it’s just gone all awry. I am going to phone his diabetic nurse tomorrow and ask her advice. He is on school break at the moment but I am worried about when he goes back to school and if we have to give him 11 or 12 units in the morning or even more. It sort of feels like his insulin isn’t working. We have even thrown away a full box of insulin and bought more thinking that it was a bad batch. That was in the first week of his sugars being higer that he is used to. We thought that it might be because he has started giving himself his insulin so we went back to giving it to him but it still seems as if it is not having the same effect. Also, another worry is that a few weeks ago for a few days we decided to eat raw food. His insuling requirements came down during those days, but we did eat plenty. I only managed to last three day before going back to our original health diet. It was after this that everything started to go wrong. Could the raw diet have triggered something? Insulin resistance or something. I am afraid I have messed up and done something very wrong. I am thinking that maybe his honeymoon period is over? COuld this be the cause? When the honeymoon period is over is that it, can I safely increase his insulin and not be afraid of him suddendly going low at school if I increase? Can someone else who has been through something like this help out?

So hes having unexplained highs?

  1. how old is he? I remember having really high readings during growth spurts and puberty

  2. How old is the insulin? did you try opening a new vial?

  3. are you injecting into scare tissue at all? this can mess up absorption

  4. did you calibrate the meter? sometimes if I dont calibrate it for a long time the readings are off…

just some trouble shooting ideas :0)

Thank you!
He is 8 nearly 9 years old and yes he is going through a growth spurt. He is otherwise in great form, not cranky or tired.
We got a brand new batch of insulin a week ago to see if it would make a difference but it didn’t.
We changed from his buttocks back to his thighs when is buttocks showed signs of getting lumpy.
I calibrated the meter yesterday to make sure.
Thanks especially because I feel like you understand and are not judging me. I feel like I am doing a terrible job at the moment.

You are doing a great job, I mean, you are here asking for help when you are out of ideas, right?

I was dx’ed at 11, so Im familiar with the strange insulin needs/growth spurt issues… even though its been some years. I would contact his endo as soon as possible to discuss his increasing insulin needs while hes going through these growth spurts. His insulin needs will most likely fluctuate… need more while growing, leveling off or decreasing while not growing, back to increasing for another growth spurt, etc.

Ask them for a sliding scale ratio of insulin, it might help better since you’ll be able to adjust his insulin needs easily and be proactive in getting those highs down

you are doing a great job, dont worry.

thanks so much for your encouragement. I am full of doubts as to how well I am doing. I feel so helpless at times and feel like I am not doing enough to help him.

As a PWD, I feel the same way about my own treatment sometimes, especially with the unexplained highs and lows. You are being a wonderful mom doing everything you can in your power and will to take the best care possible for him :slight_smile:

i’ll agree with Sarah, as the most likely candidate being the growth spurts - varying hormone levels affect his insulin requirements

Oh please do not be so hard on yourself. It is exhausting staying on top of your child’s insulin needs. I have to say…I have spent hours and constant monitoring and I still have a very hard time keeping up with my son’s numbers. It is not easy but at least we give it a good try and do our best. Are you using a carb ratio to determine his insulin needs at meals? The only thing consistent about diabetes is that it is inconsistent. There are so many factors that determine blood sugars…hormones, growth, emotions… they all tie into the blood glucose level.
Please, don’t be hard on yourself… you are actually going through normal frustration as a good and caring mom to a child that has Diabetes !

Hi Ruth,

I’d discuss with your doctor changing your son’s insulin to a basal & bolus regiment. It’s so difficult to fine tune Novamix 70/30. You also have no way to correct highs using Novamix. I don’t think this the best choice for a growing child.

It could be the end of his honeymoon period, could be a growth spurt, could be he’s eating more carbs or protein. Whatever it is, your doctor should teach you how to handle it. Insulin doses never remain the same for any of us.

You’ve done nothing wrong!

I wasn’t familiar with Novamix, but after reading a little about it, i’m a bit surprised that her MD prescribed it - from what i’ve seen, the majority of people are doing Lantus once daily and Novolog, Humalog, or Apidra at mealtimes

Not familiar with Novomix insulin or the mixed insulins. DN was dx’d at 8 and on NPH and Humalog/Regular too, I think? for first month. Sugars very high and could not really get them down below 200. At endo appointment they switched her to Lantus and Novolog and I think she had beautiful numbers within a two week period. Then she switched to the pump and has been on it for four years. It is very difficult to control blood sugars during puberty even with a pump. And I think those crazy numbers started at 11. But D did get more difficult, in general, after the first year, year and a half. Talk to your endo and see if he is on the best insulin regime, one that allows him to control the highs without too many lows (thinking Lantus, Novolog or Lantus and Humalog is usually used here for that purpose). Food is a major cause of high BS, though she eats a normal diet. If she is not hungry and, consequently, does not eat much, her numbers are a lot better. So the raw food diet may have temporarily helped with blood sugar control; not sure if it would do so permanently. Not sure if it is a good diet for a growing child. So, using a normal diet, we do pay attention to the glycemic index of her food, the mix of protein with carb and fat balance. I do not limit carb load; my sister tries to. The less the amount of carbs at a meal, easier to control BS IF she is eating the right type of food. But what we usually do is figure out how the food she eats effects BS and give insulin for that food. For instance, we give less insulin and watch for lows if she is eating Quinoa pasta; we give more insulin if she eats cereal to cover it and no cereal for breakfast when most insulin resistant. You have to watch what they eat and learn the effect of each food. After a while, you will be able to cover most things. Also take a two hour postprandial blood sugar test and analyze at that point whether more carbs are needed, or more insulin. It is very difficult. You are doing a great job. It takes a while to figure the effect of certain foods on your child’s blood sugar and learn how to compensate. And you cannot prevent a lot of postprandial highs in children because you cannot control the carb limit as you can in an adult; also carbs effect them more strongly since they have lower body weight.

I don’t know this med he’s using, but please don’t be so hard on yourself. As children grow, everything about their needs changes, and insulin is no except. I find it extremely unlikely that eating raw foods for 3 days did anything to knock him off course. Contact his endo ASAP and take a deep breath. This is not an easy disease to manage, and right now is not an easy time. You’re doing fine, Momma.

Don’t worry,you’re doing just fine. After 34 years I’m still perplexed when I suddenly need to raise my insulin or lower it unexpectedly. It was high so we raised my bedtime lantus and then suddenly I was having weekly night time lows so we cut back. It could be many, many things. He’s young so growth spurts, honeymoon period, or believe it or not, spring time. I’ve recently had months of a wonderful perfect ride, I couldn’t t TAKE a high or low BS reading even if I tried. Suddenly, about 3 weeks ago (with the first warm days) it went through the roof. I can’t keep it in range to save my life and this seems to happen every spring and every fall. It’s CRAZY!!!I’ I’ve given up trying to figure it out, it would only make me crazy and stressed (and stress will make it go crazy too!) so I just make the adjustments as quickly as I can and move on.
Good luck, try and relax. The fact you stay on top of things is the most important part, he’s learning from you that adjusting and monitoring is how to manage it and that’s what will keep him healthy and safe for the rest of his life.

Sorry, did not answer your most important question, which is about your son possibly coming out of his honeymoon. I think this is the most important reason why his blood sugars are now more difficult to manage. Although DN had short honeymoon of three or four months only, sugars pretty stable for a solid year and a half on her insulin regime after we got her stablized on Lantus/Novolog, then on pump. The reason diabetes is harder to manage after a year and a half, I think, is most beta cell function would be completely gone, even residual. Add to that the effect of growth hormones children experience that adults experience also but to a lesser extent. The growth hormone, for us, came out in the hours of 6pm through 1:30am after which she would revert to baseline. Always fluctuating every few days, always changing… keeps you on your toes, that’s for sure. For this reason, could never eliminate the 12 midnight and 2 or 2:30 a.m. blood sugar checks with adjustments. At 11 puberty kicks in and you may see huge increases of insulin needed (for us, thank God, only in the 6pm through 3am time period). But the increases in puberty are truly staggering. Things seem to have slowed down quite a bit now that she is 13. Still has spikes, still high insulin needs compared to an adult, but her rate of growth has slowed down. You will get used to the constant fluctuations, usually changes every few days. Again, watch for this during evening hours; willing to bet day time blood sugars more manageable (with the exception of the mornings where you have to be very careful what you give for breakfast to avoid highs). Keep a log book so you can chart his BS. You will then see a pattern of sorts, hopefully. Much easier to do this with the pump, I think, as basal needs are most definitely different at different times of the day… at least for us.