I know my son is sick so maybe that’s what’s causing what I’m seeing right now, but I thought I’d ask to get perspectives.
So, this morning when my son woke up his sugars were 171. I gave him his morning dose of Lantis and 1/2 dose of Humolog for his breakfast (He gets 1/2 dose for each 22.5 grams of carbs atm). I then waited 15 minutes and gave him breakfast. He ate it all…and it was around the exact amount he was given the 1/2 dose for.
He ate breakfast between 10:45 and 11:15AM.
Here it is now 12:45 (nearly 2 hours later) and his sugars spiked all the way up to nearly 400. He is 397 atm. Should the small amount of food he ate cause his sugars to spike up so high?? Is this a result of (as has been discussed in a couple other threads) needing to increase his Basal dosage?? Humolog dosage???
I’m thinking we might need to increase his bolus from 1/2 for every 22.5 to maybe 1 for every 22.5??? Right now we can’t increase without talking to the doctor, but I’m just thinking out loud and hoping to get some suggestions so that when we call the Endo to discuss this high, we can have a few recommendations or suggestions that they may be alright with us trying?
Update: My wife thinks it’s “OK” for sugars to get up into the 300’s and 400’s after eating and that it can be normal. Is this correct??? I would think it SHOULD NEVER be OK for sugars to go over 300…and if you are going above 300 with a meal, then something’s wrong. You’re either not giving enough insulin or you’re maybe giving too many carbs for the insulin that was given. I’d love to get this figured out because I hate seeing him spike after meals, but this morning is really high…even higher than usual. I know his sickness may be feeding into it a little, but it’s over 400 now…
Small doses such as 1/2 unit of Humalog are very unreliable. Have you talked to your endo about diluting the Humalog so you can get better control of dosing?
Right now the receiver is reading “High” and it’s been over 350 for now 30 minutes or so. I just gave him his Humolog at 1030 so I can’t even give him another shot until 1330.
I just hate to sit and be helpless basically…
My wife seems to think it’s maybe due to what he ate?? He only wanted chicken nuggets this morning so he had 9 of those, and a small sip of milk (not even 1/4 cup…just 3 sips or so.)
Diluted HUMALOG U-100 for Subcutaneous Injection — HUMALOG may be diluted with Sterile Diluent for HUMALOG for subcutaneous injection. Diluting one part HUMALOG to nine parts diluent will yield a concentration one-tenth that of HUMALOG (equivalent to U-10). Diluting one part HUMALOG to one part diluent will yield a concentration one-half that of HUMALOG (equivalent to U-50).
You should talk with your endo about this. You can obtain diluent from your pharmacy who may have to special order it. If you dilute as above to U-10 you can dose down to the 0.1 unit. You simply use a regular U-100 syringe and divide the numbers by ten. Until you are comfortable with this you should have your pharmacist or endo perform the dilution and go over the details with you carefully.
Here’s a video on diluting insulin from the well respected endo Dr Bernstein
When you say “1/2 a dose” do you mean 1/2 a unit of insulin?
also If I were you, I’d call his endo today. Make it clear that he’s sick. You are new to all this, and a call to the endo for sick day guidance is not out of line. 300s feel just awful. Make sure your little guy gets plenty of water when he’s that high. It’s very dehydrating.
It’s about as “normal” as an exploding bomb. A non-diabetic person, barring catastrophic injury, will never see numbers anywhere close to that range. It’s anything but “OK”. Depending on the particular individual, the upper end of that range can be flirting with DKA, or at least skating close to the line. This is danger territory; those numbers are never “OK” and should not be tolerated when a remedy is available. Ever.
Why are you hesitant to correct again when he is that high? 300 is very high. 400 is horribly high!!!
If your son’s endo is OK with these kinds of numbers (and based on your posts, I’d estimate that your son spends over 50% of the time in the 200s to 400s), I’d be looking for a new endocrinologist. Seriously.
I’m afraid of stacking insulin. He had Humolog at 1030 so I was in the “wait for the insulin on board to work” phase. I didn’t want to give more and cause a serious low.
At 400, a low is not what you should be worrying about. 400 is what to be worrying about. If you’re concerned about a notional low, start with small doses and work up carefully, monitoring as you proceed. But doing nothing at 400 is . . . well, please forgive me, but the only correct word is “irresponsible”.
Please don’t call it, or us, irresponsible. That’s pretty offesive to two parents just trying to figure this disease out and being told different things from different sources. We are doing our best to figure this out as quickly as we can. Hopefully you can remember when you were first diagnosed, and I hope you never have to experience a toddler with T1.
Btw. I ended up giving him a correction of 1.5 units and he dropped low…to 50.
Happy for those who are able to stay in the 70- 150 range but that doesn’t speak to us being responsible or not. Maybe one day we will be there, but we’re struggling to just figure out triggers at this point.
What was coming across sounded like a willingness to just let the 400 be and wait to see what happened. Sorry again if I misread what you were trying to say.
You didn’t misread what I wrote other than to assume “willingness.” As soon as it started rising I reached out to you all, I talked to my wife, we called the doctor, and I entertained “stacking” IOB.
By the time we talked to the doctor, the three hour window had passed so I gave him the correction. There wasn’t any willingnes…only trying to make the best decision. My wife can attest to the fact that I was (and continue to be) very stressed about his high BGs.
If you could only be a fly on my wall, or read my overloaded, stressed out, brain.
There is only “willingness” to figure this out ASAP.
My major concern is WHEN is it OK to give more insulin and when is it NOT OK? If we administer Humolog at 10:30 and his sugars don’t drop in 1 or 2 hours, is it OK to give him more???
What if today happens again? Just give more insulin in small .05 unit doses until it DOES start going down??
:: sigh :: This is so tough…every breath I take, every waking moment and in my sleep nothing else consumed my thoughts than my Son’s T1…how to manage, what his future is going to be like, how can I improve his quality of life, etc., etc., I just want to get my sons BG into that happy good fairy land range that so many here seem to be in…
I think we need to understand there is a lot more concrern with stacking insulin in a toddler vs. an adult. Completely different risk levels. My heart goes out to anyone who has a toddler with diabetes.
Understand. I do apologize for adding another straw to the pile, And it is overwhelming in the beginning. The good news is that it does not stay that way. It will start coming into focus sooner than you may think. In the meantime, focus on learning one thing at a time until it does. As a really smart and (unfortunately) anonymous person once said, “Diabetes is a marathon, not a sprint.”
