Worried about my daughters bgl's

All pretty standard for the first week or two after dx. Takes time to work out those carb and sensitivity ratios, so they give you some set doses to work with until you can get those appointments lined up. Meanwhile, yup, lows are scarier than highs for the most part, so they err on the side of caution at first. Try to be patient bringing down the highs, have sugar available that you can give in easy increments.

A LOT of T1s prefer Skittles btw, because they’re 1 carb per Skittle, so it’s easy to keep track.

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For the average adult 1 gram of glucose will increase BG by 5mg/dl. So for a 6 year old you could probably cut that in half to 1 gram glucose to every 10 points you want to raise her. I personally would try a easier to measure fast acting sugar like glucose tablets although it may be hard to get a little kid to actually eat them as they can taste pretty chalky.

You do need to give the quickest acting kinds of sugar for severe lows so whatever you try make sure it is something that the body doesn’t have to process down into glucose. Once she is back up into range follow up with some longer lasting carbs like half a peanut butter and jelly sandwich and give insulin with it. The fat and carbs together will help level out her BG and the correct dose of insulin will blunt the spike.

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Yes her school is starting in early September

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My son starts back next week and I am a nervous wreck! I can’t imagine how you must feel with your daughter only being 6! Just hang in there, hopefully bf school starts for her you can have her insulin adjusted properly! How is she doing tonight? BG good?

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@T1DMom yes last night was good she went to sleep with 173 bgl and at 3.50am her bgl was low to 63 so I gave her flavored milk 1 cup she woke up with 73 bgl at 8.30am

Very good, sounds like her basal insulin (long-lasting) is set too high, record everything and take in with you when she sees the Endo!

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I am a fan of adjusting the basal rates ourselves and giving the Doc an FYI. Sometime FYI via message when we do something and sometimes just wait for our next Endo appt and let the Doc know then what we are doing.

As @T1DMom says when the basal rate seems obviously off then we would adjust it.

When we adjust our basal rates, I like to make adjustments in the range of plus or minus 15% and then give that change a few days to see how it is working before making another change.

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I absolutely love the way you own your child’s treatment choices and decisions! I hope I can gain this sort of confidence once I am feeling more comfortable with insulin in general!

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If funny you say this bc his Endo told me at his first month appointment in July that one day he would be taking orders from me about Aaron’s treatment and what’s best for him! I found it hard to believe right then!

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My wife has been on insulin for over 22 years and STILL doesn’t feel all that comfortable with insulin. :slight_smile: Me, I’ve made my peace with it when I got my first pump, and then a few months later, Humalog came onto the market (late 1996). Before that, insulin-taking freaked me out–not the actual injections, but the results (or lack of results).

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I do a good portion of the basal adjustments by going into the Dexcom Clarity online reporting and based on the 14-day AGP graph, often times there will be obvious basal adjustments called for.

If you have not started looking at these reports (assuming Dexcom use obviously) then I would highly suggest logging in and taking a look.

Ask if you have questions about the report.
After logging in to Dexcom Clarity, click on the AGP menu option.

This is a very intuitive online reporting system but there actually is a user guide for it which could explain a few things which perhaps are not immediately obvious.

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@Tim35 Are those the same reports you can generate on the clarity phone app?

@Jason99

Actually I have never used the Clarity Phone App !!!

lol

I’ve never used clarity on anything but the phone app. Ain’t we a pair

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Huh?

Your endo is a keeper!

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“If funny you say this bc his Endo told me at his first month appointment in July that one day he would be taking orders from me about Aaron’s treatment and what’s best for him! I found it hard to believe right then!”

That Endo really said a great thing to inspire and motivate you as a parent to learn all you can and take the bull by the horns. How nice to hear.

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I second the advice on getting a CGM, which I have used to 15 years (65 yrs T1D) and it makes a HUGE difference since it shows rise and fall rates so you can anticipate highs and lows. I always use glucose (tablets or gel) to counteract lows, because a complex sugar like honey can take an hour to bring the BGL up very much, but then continues to raise it for a very long time (possibly the reason for the 300+). If my CGM (Dexcom G6) shows I am at 65 BGL I take four glucose tablets and am at 80 in 15 to 20 minutes and peak somewhere around 140 in another 15 minutes. For a child (I weigh 170#) one tablet (4g glucose) should correct a low glucose level fairly quickly (but I am not a physician so please verify all of this with your doctor).
I like to eat dinner four hours before bedtime, and with a basal insulin (Tresiba) I can stay between 100 and 130 'til morning.

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Wt do we do if t1 gets cough running nose… do we take different kind of medications?

@mariam

Sick Days:

Monitor BG. Watch the Dexcom and double check with a meter.

Doc should have provided “Sick Day” instructions.

For us, being sick causes a persistent elevated BG.

We push low or zero carb fluids. Don’t want to add dehydration on top of everything else. It is easy to end up in the ER simply from dehydration.

Check ketones. If large ketones present at any point, call your Endo.

And we will give an insulin bolus every two hours. Our objective during sick days is to get the BG under 200. BG will not come down without insulin. For us during sick days, it takes a lot of insulin. What is “a lot of insulin?” Different for different people. For us it is much more than we would normally use.