Here’s how the afternoon/evening went (you can see the timeline below) I’m not sure what I should have done differently. Maybe I should have waited on correcting the high bg post gymnastics to see if it came down on it’s own? Maybe I shouldn’t have covered her bedtime snack? Now what? Is she going to spike because I gave her carbs to get her bumped back up for sleep and lowered her basal? If so, do I wait until morning to correct since she’s been so active it might come down on it’s own? Naomi has a natural decrease of at least 50 from 3am-5:30am daily no matter what. Any help would be so appreciated!
4:00 – Gymnastics – disconnect from pump for class
5:25 – Reconnect to pump, 38 carb dinner, + bg correction (forgot what it was, 200+)
6:20 – Musical Theatre/Dance
7:15 – Leave class early, bg @ 279, tummy ache, tired
8:15 – In bed, quick easy 14 carb snack (protein drink & fudgecicle) bg @248 (give correction & covered carbs with insulin)
8:45 – Dexcom alerts to 2ml drop/minute, bg @ 170
9:30 – BG @ 150
10:30 – BG @ 100, decreased basal -50% for 3 hrs, 8 carbs, g-tabs, no bolus 2 cover
11:15 – BG still only @ 109, gave another 4 carb g-tab, no bolus 2 cover
11:30 – BG back @ 100. GRRRRRR……8 carb Glucose Boost drink, no bolus to cover
12:00 – BG @ 155, okay…now what’s going to go on?
Just a few ideas for you but my son is a teenager so things are a litte different.
I was always afraid that my son would be low during hockey but really the opposite is true. In a game his BG rises due to the exertion and adreneline. Your daughter may need some insulin (even at a reduced rate) to keep from having extreme highs during gymnastic and dance. If he gets an extreme high, which we have been working to avoid, he will also crash 6 hours later with an extreme unexplained low. We now know to watch for it - I even set the alarm clock or timer at home and am teaching him to set an alarm on his cell phone.
We were originally told not to correct the adreneline highs but our new CDE doesn’t want him going to bed so high because he doesn’t always drop and then feels really bad in the morning. It is a long time to be out of range but lows at night scare me. She would rather he correct to his bedtime normal and temp his basal down until 2pm. At 3pm being a teenage boy his hormones cause a high, so he has a different basal rate for 3-6 am. With your data on the Dex, I would think your daughter could benefit from a lower basal rate starting at 2am also.
We have been working with the new CDE since March and she has really got his pump humming. Based on his downloaded readings yesterday, she projects his A1C should be between 5.5 and 6.0. He was previously 8 + partly due to all of the hockey highs.
At 5:25 I would have probably covered the carbs in case you didn’t do that. If you disconnect her you will probably notice she is high a couple hours later due to the lack of basal …
Regarding corrections at first I did not correct unless 4 hours passed since her last correction.
If you notice she goes low after her food bolus, her I:c ratio must be too low.
Just some ideas…
We found that our son has lows hours after exercise. Also, the tummy ache could have contributed. We find that with stomach issues food is not absorbed the same so bolusing for the full number of carbs sometimes results in lows.
My daughter Isabelle just started on her pump (Animas Ping) on Monday. She is three years old. Being so new, I have no advice I can offer, but I just wanted to say that I feel your frustration and wish you all the best in your daughters care! Messages like this really help me to gain knowledge. Keep us informed of how she is doing. By the way, how old is she?
First of all, congratulations! Compared to my own experience with my son during the first few weeks of pumping, your BGs are stellar! It really does take a while to fine tune those pump settings, and I found it totally perplexing how it didn’t really match up to his previous intake of lantus and humalog. Granted, this was only a month or so out from diagnosis…
But still, good job.
It might be hard to tell where to fine tune settings-wise with all that tinkering. The changes our endo and CDE made to our settings seemed so slow to me, but they wanted more data with which to make their decisions. I’m not relying on them anymore for changing pump settings outside of the occasional check up, but their method was a good one at the beginning. Also, I’d recommend the book Pumping Insulin by John Walsh.
That disconnecting for gymnastics though is a great question to ask on its own for all those parents of kids in sports out there. Good luck!
I know what you mean. My daughter had her first dance recital this year. There were two days. On the first day I left her pump on and she was completely fine. The second day I had to give her three juices and could not get her to go up for anything. After the first low I removed her pump and that didn’t even help. I don’t know this whole thing stresses me out sometimes. I try not to get too crazy about it but I know about being up at 12:30 and not knowing what to do.
I don’t have a lot of answers for you but I wanted you to know there is someone else who feels your pain.
I also wanted to tell you GREAT JOB!!! Sometimes we just need to hear that!
