1 year ago
Showing posts with label highs. Show all posts
Showing posts with label highs. Show all posts
Sunday, March 11, 2018
Monday, December 26, 2011
Pod change highs
Well, it's been almost two months since we started pumping, and things have been much better after a very rocky start.
(That is until, as you all predicted, those lows that we were having turned into heinous highs when the full-extent of Elise's illness showed it's ugly face and that coupled with the craziness of Christmas her numbers have been so coo-coo bananas that I don't even know where to start to fix them).
Holy run-on sentence, Batman.
Anyway, the one issue that is vexing me every three days is those pesky post-pod-change highs. Elise skyrockets into the 300s and doesn't come down for a looooong time; sometimes it can take up to 8 hours.
I don't think it's due to stress. Elise is pretty cool when it comes to changing the pod. I hand her the PDM and she presses the button like it's no big deal.
We also usually do it right before a meal, so I can give her a big-ass bolus. Take today for example:
She was 108 pre-change. We had an issue, and had to discard two pods, so the change took a bit longer than usual, but she was only "disconnected" for 10 minutes.
I bolused her for her dinner, plus another .5 of a unit for good measure. That's a lot of insulin for Elise... a dose like that should drop her by about 125.
She ate, and two hours later was at 340. I corrected and 2 hours after that she was at 359. BLERGH!
I'm hesitant to give her too much insulin because we're without the dex, and I find I am so much more cautious when I don't have a continuous flow of numbers to help guide me. I'm also less aggressive with corrections.
Can anyone tell me what I am doing wrong? Should I bolus her more? Do a change when it's NOT a meal time? Do a temp basal after I change? Does anyone have any tips that have helped them with this? And is this just a pod issue, or do kids who wear Animas or Medtronic also go through this with site changes?
Help me DOC, you're my only hope!
(yeah... I'm a nerd. So?)
(That is until, as you all predicted, those lows that we were having turned into heinous highs when the full-extent of Elise's illness showed it's ugly face and that coupled with the craziness of Christmas her numbers have been so coo-coo bananas that I don't even know where to start to fix them).
Holy run-on sentence, Batman.
Anyway, the one issue that is vexing me every three days is those pesky post-pod-change highs. Elise skyrockets into the 300s and doesn't come down for a looooong time; sometimes it can take up to 8 hours.
I don't think it's due to stress. Elise is pretty cool when it comes to changing the pod. I hand her the PDM and she presses the button like it's no big deal.
We also usually do it right before a meal, so I can give her a big-ass bolus. Take today for example:
She was 108 pre-change. We had an issue, and had to discard two pods, so the change took a bit longer than usual, but she was only "disconnected" for 10 minutes.
I bolused her for her dinner, plus another .5 of a unit for good measure. That's a lot of insulin for Elise... a dose like that should drop her by about 125.
She ate, and two hours later was at 340. I corrected and 2 hours after that she was at 359. BLERGH!
I'm hesitant to give her too much insulin because we're without the dex, and I find I am so much more cautious when I don't have a continuous flow of numbers to help guide me. I'm also less aggressive with corrections.
Can anyone tell me what I am doing wrong? Should I bolus her more? Do a change when it's NOT a meal time? Do a temp basal after I change? Does anyone have any tips that have helped them with this? And is this just a pod issue, or do kids who wear Animas or Medtronic also go through this with site changes?
Help me DOC, you're my only hope!
(yeah... I'm a nerd. So?)
Tuesday, September 6, 2011
The day the beta cells died
Three years ago today, Elise was diagnosed with diabetes.
The call to take her to the hospital came in the middle of her birthday party.
She was 12 months old.
So how did Elise's pancreas celebrate? I think by completely quitting on us. The amount of insulin we have given her over the last few days is incredible.
We gave her TWO shots in the middle of the night. That is unprecedented.
We used full strength to correct her. Also unprecedented.
She spent most of the night in the 400s, only dipping into the mid 200s after a 1/2 unit of full strength.
Today was also her first day of school. She felt awful. She bawled when we left her. She was high the entire morning.
Today I hate diabetes just as much as I did 3 years ago.
The call to take her to the hospital came in the middle of her birthday party.
She was 12 months old.
So how did Elise's pancreas celebrate? I think by completely quitting on us. The amount of insulin we have given her over the last few days is incredible.
We gave her TWO shots in the middle of the night. That is unprecedented.
We used full strength to correct her. Also unprecedented.
She spent most of the night in the 400s, only dipping into the mid 200s after a 1/2 unit of full strength.
Today was also her first day of school. She felt awful. She bawled when we left her. She was high the entire morning.
Today I hate diabetes just as much as I did 3 years ago.
This picture was taken right before Elise's diagnosis. As I searched through the pictures from that time period, I was hard-pressed to find one in which she was smiling.Saturday, July 2, 2011
P.S. I'm gonna punch you in the nuts
Dear Diabetes,
It has been awhile since I've felt compelled to write you a letter. But you've been a real pain in the ass lately, and today was the high that broke the camel's back.
You see, Elise was at a birthday party today. We almost didn't go because it was outside at a splash park, and the heat and sun makes her rash feel worse. But we decided to dose her up with some benadryl and let her have some fun.
Except that she didn't. Because of you. I was encouraged when she woke up at a nice 108 this morning (that after a middle of the night correction which she fought, and all the screaming woke up her brother... but that is another bitch session for another time).
But when party time came, she was in the upper 200s and rising. We skipped her snack, hoping that would even things out. She kept going higher. Her tummy hurt. She was crying. She wouldn't pose or smile for any pictures and she spent most of the party huddled on my lap. When she did try to play, the stomach pain was so bad all she could do is stand there, bent at the waist and holding her tummy while she cried out.
You are one shitty disease, diabetes.
When it came time for food, my friend let me know that there was pizza, but she had also ordered some chicken strips for Elise if we wanted those.
We asked Elise if she was hungry. She didn't answer. We asked if she wanted some chicken strips. She said no.
She had seen the pizza, and that was what she really wanted, but didn't want to ask. She knows it's hard on her blood sugars. She knows she doesn't feel good after she eats it (to be clear here, we have NEVER said this to her, and we have never NOT let her eat pizza. She's just smart, and she just knows). We told her if she wanted pizza, then that's what she could have.
I think she just felt too awful to eat, because she just sat on my lap; head resting on my shoulder, while all the other children laughed and played in the water. The juxtaposition between Elise and the other kids was glaringly and heart-breakingly obvious.
The day didn't totally belong to you, diabetes. Elise did get to enjoy some cake; icing and all. Who cares that she ate it in place of her lunch. Or that her BG was 280. She ate it and loved every second of it.
So suck on that, you craptastic piece of trash of a disease. It may be a small victory, but we'll take it. Tomorrow is another day and rest assured I will resume kicking your ass then.
Yours VERY sincerely,
Elise's Pancreas by proxy
It has been awhile since I've felt compelled to write you a letter. But you've been a real pain in the ass lately, and today was the high that broke the camel's back.
You see, Elise was at a birthday party today. We almost didn't go because it was outside at a splash park, and the heat and sun makes her rash feel worse. But we decided to dose her up with some benadryl and let her have some fun.
Except that she didn't. Because of you. I was encouraged when she woke up at a nice 108 this morning (that after a middle of the night correction which she fought, and all the screaming woke up her brother... but that is another bitch session for another time).
But when party time came, she was in the upper 200s and rising. We skipped her snack, hoping that would even things out. She kept going higher. Her tummy hurt. She was crying. She wouldn't pose or smile for any pictures and she spent most of the party huddled on my lap. When she did try to play, the stomach pain was so bad all she could do is stand there, bent at the waist and holding her tummy while she cried out.
You are one shitty disease, diabetes.
When it came time for food, my friend let me know that there was pizza, but she had also ordered some chicken strips for Elise if we wanted those.
We asked Elise if she was hungry. She didn't answer. We asked if she wanted some chicken strips. She said no.
She had seen the pizza, and that was what she really wanted, but didn't want to ask. She knows it's hard on her blood sugars. She knows she doesn't feel good after she eats it (to be clear here, we have NEVER said this to her, and we have never NOT let her eat pizza. She's just smart, and she just knows). We told her if she wanted pizza, then that's what she could have.
I think she just felt too awful to eat, because she just sat on my lap; head resting on my shoulder, while all the other children laughed and played in the water. The juxtaposition between Elise and the other kids was glaringly and heart-breakingly obvious.
The day didn't totally belong to you, diabetes. Elise did get to enjoy some cake; icing and all. Who cares that she ate it in place of her lunch. Or that her BG was 280. She ate it and loved every second of it.
So suck on that, you craptastic piece of trash of a disease. It may be a small victory, but we'll take it. Tomorrow is another day and rest assured I will resume kicking your ass then.
Yours VERY sincerely,
Elise's Pancreas by proxy
Tuesday, March 8, 2011
Telling you why I don't like Mondays
Actually, this story begins on a Sunday, but let's not focus on such trivial matters.
I should have known something was off when Elise fell asleep Sunday afternoon. She hasn't napped in almost 6 months, but both she and Mattias were in snoozeville, so I counted my blessings and settled down on the sofa to play a game of Angry Birds.
Dinnertime and she was still asleep, so wandered into her room to check her BG. High 200s and .5 ketones. I gave her her insulin and about 5 minutes later she woke up. And she didn't look good. And she felt like she was on fire. Temperature was 102.3.
Oh oh. Did I mention I gave her some insulin? How completely sucktacular.
Upon being questioned, she said that she would eat, but nothing sounded good to her. Except for maybe McDonalds fries. I debated if that would be a good choice of food if there were going to ensuing tummy troubles. I managed to track Fred down (who was at a hospital visiting a neighbour and did not have his phone on him), and asked him to pick up some fries. Elise's dinner that night was diluted OJ, and french fries.
Her BG remained high all night, but the fever came down with some advil (which I think had a hand in making her BG soar). A correction was given, but I was afraid to give too much insulin because of all the horror stories I've been hearing lately about sickness and lows. Her ketones were always below .5, so I wasn't that worried.
So onto to Monday... luckily, Mattias had his 6 month well child visit scheduled, and the doc said it was okay to bring Elise in too. After a two hour visit, Elise's nose and throat swabs were all negative, as was her urine sample. Thank goodness (?) her temperature was 101.8, or nobody would have believed me that she was sick for all the singing and dancing around the office she was doing. The only thing the doc noticed is that Elise throat was a little red. Mattias also did great, making him a shoo-in for the Best Baby Ever award.
At lunch on Monday, we were going to debut Mattias's first ever solids. I was sure he was going to love it. Except that he didn't. In fact, he was rather insulted by the whole thing. At one point, he pounded his tiny fist into the bowl, sending it flying up into the air and emptying the contents on him, me, the dog, and pretty much anything in a three foot radius.
I decided that it was time to put away the solids. I took his tray off of his high chair, turned around and then heard a thump, then shriek. It seems somewhere along the line, I had forgotten to strap in him into his chair and he fell three feet onto our hardwood floor. I really am the Worst Mother Ever. I can't even explain how terribly CRAPPY I'm STILL feeling about it.
So there I was holding a screaming, sticky baby. I'm covered in rice cereal and having a heart attack thinking that I had broken him. Fred comes rushing into the kitchen and I start screaming about taking Mattias to the ER and that Fred had to cancel the showing.
Wait... did I forget to mention that we had a house showing that afternoon and only 4 hours to clean the house?
So I called a friend (thanks Liz!!!) who lives nearby (because I needed someone to sit in the backseat and watch Mattias for me), and drive about 90 miles an hour to take Mattias to the Children's ER. Leaving poor Fred to clean up the house (because we really can't afford to say no to anyone who wants to see it), and care for Elise, on top of having to deal with his work stuff.
A nearly 3 hour ER visit, 2 head x-rays, and a hefty co-pay later confirmed two things; Mattias is going to be okay (I didn't break him after all), and that I have the cutest, happiest baby in the world (as per the hospital staff).
I returned home to find that Fred had indeed cleaned the house... to the extent that it looked like nobody lived there anymore. Everything had been moved to the garage. One day later, I'm still looking for stuff I use on a daily basis... like my thyroid meds. Thankfully, I was able to combine two doses from some old prescriptions to make the dose I usually take.
And to round off this craptacular day, Elise's dex read HIGH pretty much all evening. Even for two hours after I rage-corrected her. Stupid unknown illness.
I don’t like Mondays.
I wanna shoo-oo-oo-oo-oo-oot the whole day down.
I should have known something was off when Elise fell asleep Sunday afternoon. She hasn't napped in almost 6 months, but both she and Mattias were in snoozeville, so I counted my blessings and settled down on the sofa to play a game of Angry Birds.
Dinnertime and she was still asleep, so wandered into her room to check her BG. High 200s and .5 ketones. I gave her her insulin and about 5 minutes later she woke up. And she didn't look good. And she felt like she was on fire. Temperature was 102.3.
Oh oh. Did I mention I gave her some insulin? How completely sucktacular.
Upon being questioned, she said that she would eat, but nothing sounded good to her. Except for maybe McDonalds fries. I debated if that would be a good choice of food if there were going to ensuing tummy troubles. I managed to track Fred down (who was at a hospital visiting a neighbour and did not have his phone on him), and asked him to pick up some fries. Elise's dinner that night was diluted OJ, and french fries.
Her BG remained high all night, but the fever came down with some advil (which I think had a hand in making her BG soar). A correction was given, but I was afraid to give too much insulin because of all the horror stories I've been hearing lately about sickness and lows. Her ketones were always below .5, so I wasn't that worried.
So onto to Monday... luckily, Mattias had his 6 month well child visit scheduled, and the doc said it was okay to bring Elise in too. After a two hour visit, Elise's nose and throat swabs were all negative, as was her urine sample. Thank goodness (?) her temperature was 101.8, or nobody would have believed me that she was sick for all the singing and dancing around the office she was doing. The only thing the doc noticed is that Elise throat was a little red. Mattias also did great, making him a shoo-in for the Best Baby Ever award.
At lunch on Monday, we were going to debut Mattias's first ever solids. I was sure he was going to love it. Except that he didn't. In fact, he was rather insulted by the whole thing. At one point, he pounded his tiny fist into the bowl, sending it flying up into the air and emptying the contents on him, me, the dog, and pretty much anything in a three foot radius.
I decided that it was time to put away the solids. I took his tray off of his high chair, turned around and then heard a thump, then shriek. It seems somewhere along the line, I had forgotten to strap in him into his chair and he fell three feet onto our hardwood floor. I really am the Worst Mother Ever. I can't even explain how terribly CRAPPY I'm STILL feeling about it.
So there I was holding a screaming, sticky baby. I'm covered in rice cereal and having a heart attack thinking that I had broken him. Fred comes rushing into the kitchen and I start screaming about taking Mattias to the ER and that Fred had to cancel the showing.
Wait... did I forget to mention that we had a house showing that afternoon and only 4 hours to clean the house?
So I called a friend (thanks Liz!!!) who lives nearby (because I needed someone to sit in the backseat and watch Mattias for me), and drive about 90 miles an hour to take Mattias to the Children's ER. Leaving poor Fred to clean up the house (because we really can't afford to say no to anyone who wants to see it), and care for Elise, on top of having to deal with his work stuff.
A nearly 3 hour ER visit, 2 head x-rays, and a hefty co-pay later confirmed two things; Mattias is going to be okay (I didn't break him after all), and that I have the cutest, happiest baby in the world (as per the hospital staff).
I returned home to find that Fred had indeed cleaned the house... to the extent that it looked like nobody lived there anymore. Everything had been moved to the garage. One day later, I'm still looking for stuff I use on a daily basis... like my thyroid meds. Thankfully, I was able to combine two doses from some old prescriptions to make the dose I usually take.
And to round off this craptacular day, Elise's dex read HIGH pretty much all evening. Even for two hours after I rage-corrected her. Stupid unknown illness.
I don’t like Mondays.
I wanna shoo-oo-oo-oo-oo-oot the whole day down.
The spoon was a hit. The food... not so much
Tuesday, February 22, 2011
I should be sleeping...
But instead I decide to blog. Hey... free therapy, right?
So many things on my mind and I need to just get it out:
-First, thanks for all the sweet comments on my last post. Unfortunately, we don't have family here, but I have had two friends volunteer to come help out around the house. I'd love to get some sleep in during the day, but there is just too much to do...
-Because we put an offer on a house, they countered and we accepted.. YIKES! Now we have two months to sell our place. Have I mentioned that it looks like a land fill threw-up around here lately?
-I did get a bit more sleep last night, although Mattias woke me up at 1:30 am to eat. Fred wasn't in bed yet, and when I looked for him, he was sitting on the sofa folding the laundry (4 baskets full!!!). He had also started the remove some of the clutter from our downstairs area. Crazy man... I love him.
-Elise's BG was 480 at 1:00 am last night. We never see numbers like that. We rarely see numbers above 300, so it freaked me out when Fred told me. She had the same bedtime snack as always, and the same amount of insulin (which sent her low the night before), so I don't know what it could have been. It wasn't a missed low, because she was 200 at bedtime and headed steadily up after that (via the CGM).
-Even though her BG was that high, she had no ketones. Weird.
-After her correction, she woke up this morning at 240. Well, my first check showed 337, so I corrected her for that. Then the CGM asked for a re-check, so when I did I got 245, and 240. UGH!!!
-She went off to school and at 11:00 am, I got a phone call. Her teacher said her CGM was reading HIGH, and a finger check showed 405. HUH?
-After last night's high numbers and today's lunchtime high number, I can only conclude her NPH is bad. This is the first time we've ever had a bad vial of insulin in the 2 1/2 years we've been doing this.
-Have I said thank you enough for your comments and support? They are better than candy... which I have been stress-eating at every opportunity. I blame Target for selling their Valentine's candy at 75% off.
-I am officially going to bed now. Good night.
So many things on my mind and I need to just get it out:
-First, thanks for all the sweet comments on my last post. Unfortunately, we don't have family here, but I have had two friends volunteer to come help out around the house. I'd love to get some sleep in during the day, but there is just too much to do...
-Because we put an offer on a house, they countered and we accepted.. YIKES! Now we have two months to sell our place. Have I mentioned that it looks like a land fill threw-up around here lately?
-I did get a bit more sleep last night, although Mattias woke me up at 1:30 am to eat. Fred wasn't in bed yet, and when I looked for him, he was sitting on the sofa folding the laundry (4 baskets full!!!). He had also started the remove some of the clutter from our downstairs area. Crazy man... I love him.
-Elise's BG was 480 at 1:00 am last night. We never see numbers like that. We rarely see numbers above 300, so it freaked me out when Fred told me. She had the same bedtime snack as always, and the same amount of insulin (which sent her low the night before), so I don't know what it could have been. It wasn't a missed low, because she was 200 at bedtime and headed steadily up after that (via the CGM).
-Even though her BG was that high, she had no ketones. Weird.
-After her correction, she woke up this morning at 240. Well, my first check showed 337, so I corrected her for that. Then the CGM asked for a re-check, so when I did I got 245, and 240. UGH!!!
-She went off to school and at 11:00 am, I got a phone call. Her teacher said her CGM was reading HIGH, and a finger check showed 405. HUH?
-After last night's high numbers and today's lunchtime high number, I can only conclude her NPH is bad. This is the first time we've ever had a bad vial of insulin in the 2 1/2 years we've been doing this.
-Have I said thank you enough for your comments and support? They are better than candy... which I have been stress-eating at every opportunity. I blame Target for selling their Valentine's candy at 75% off.
-I am officially going to bed now. Good night.
Wednesday, December 8, 2010
If I don't get off this coaster soon, I just might vomit
As I was perusing my D-Mom and D-Dad blogs a few days ago, I noticed a common thread... there are a lot of us riding the glucose roller coaster right now. And I'm wondering what planets are in alignment to unleash this hell upon us.
For us, it started off with just dinner problems; we had to start giving Elise her insulin about 25 minutes after she started eating because if we gave it any sooner, she would drop low, we would have to give her some fast-acting carbs, then she would sky-rocket from all the extra carbs.
But it's still not a fix... as we watch the CGM we see that she holds steady while she's eating (once we had a record 45 minutes steady BG, she didn't start rising until after she had finished eating). We usually give her the shot as soon as we see the slanted arrow up appear. Unfortunately with this method, we get double arrows up into the 300s, then double arrows down. All in the span of an hour. If I give it any earlier, she crashes.
Tonight, she was 151 going into dinner. I gave her 1.5 units for almost 40g of carbs. She held steady for 25 minutes and started to go up. I gave her the shot, and in 30 minutes, she's almost at 300 with double arrows up. I looked at the CGM 20 minutes later and she's at 179 with double arrows down. And 15 minutes after that, she's 96, double arrows down. She's 84 via her meter, so I give 7g. Now I'm just waiting for the spike to happen (and it will).
My brain is so fried from trying to figure this out. This issue only happens at dinner. Her ratio at dinner is now over twice what it is in the morning. I think our next step is to go back to diluted insulin at dinner time. I can't stand to see the peaks and valleys on the CGM, but I'm too afraid to take it off of her for fear of missing a crash.
I have never felt this helpless, useless, and downright hopeless before. Nothing we try has worked. And it's got me in a funk. I think we've had smooth sailing for so long, I don't have the capacity to deal when I can't figure it out. If you've been reading my blog for awhile, you know that we don't bother with the CDEs at our endo because they have proven themselves useless time and time again. Talking to them would drive me to tears.
Thankfully, we do have an endo appointment in 9 days. But I don't think I'm going to last that long.
For us, it started off with just dinner problems; we had to start giving Elise her insulin about 25 minutes after she started eating because if we gave it any sooner, she would drop low, we would have to give her some fast-acting carbs, then she would sky-rocket from all the extra carbs.
But it's still not a fix... as we watch the CGM we see that she holds steady while she's eating (once we had a record 45 minutes steady BG, she didn't start rising until after she had finished eating). We usually give her the shot as soon as we see the slanted arrow up appear. Unfortunately with this method, we get double arrows up into the 300s, then double arrows down. All in the span of an hour. If I give it any earlier, she crashes.
Tonight, she was 151 going into dinner. I gave her 1.5 units for almost 40g of carbs. She held steady for 25 minutes and started to go up. I gave her the shot, and in 30 minutes, she's almost at 300 with double arrows up. I looked at the CGM 20 minutes later and she's at 179 with double arrows down. And 15 minutes after that, she's 96, double arrows down. She's 84 via her meter, so I give 7g. Now I'm just waiting for the spike to happen (and it will).
My brain is so fried from trying to figure this out. This issue only happens at dinner. Her ratio at dinner is now over twice what it is in the morning. I think our next step is to go back to diluted insulin at dinner time. I can't stand to see the peaks and valleys on the CGM, but I'm too afraid to take it off of her for fear of missing a crash.
I have never felt this helpless, useless, and downright hopeless before. Nothing we try has worked. And it's got me in a funk. I think we've had smooth sailing for so long, I don't have the capacity to deal when I can't figure it out. If you've been reading my blog for awhile, you know that we don't bother with the CDEs at our endo because they have proven themselves useless time and time again. Talking to them would drive me to tears.
Thankfully, we do have an endo appointment in 9 days. But I don't think I'm going to last that long.
Monday, June 21, 2010
I take it all back... we suck.
Calling on all my D-Peeps for some help here. Fred and I are stumped beyond belief at a trend of numbers Elise has been having lately. I blame it on my proclamation that we are "freaking rock stars".
Anyway... for the last three days, when we check Elise for her pre-bedtime snack, she's in the mid-300s. We give her a snack and her bedtime NPH, and usually somewhere between 9:30 and 11:00, she falls low. We give her some carbs and she rebounds into the 300s during the night, waking up in the mid-200s. The timeline looks like this:
5:00 pm - shot + dinner. Usual carb ratio.
7:30 pm - bedtime check. In the 300s.
Between 8:00 - 9:00 pm - bedtime snack (15g) and NPH.
Between 9:30 - 11:00 pm - Elise's BG is in the 70s. We give her carbs.
1:30 am - BG in the 300s.
Is it possible that her fast-acting insulin she gets at dinner (diluted Humalog) is peaking 4 - 5 hours after she gets her shot?
Is it the combination of her DH and NPH making her go low (are we giving the two shots too close together, which is approx 3 1/2 hours apart)?
Is the NPH now peaking earlier than it ever has?
Keep in mind, we are doing EVERYTHING the exact same as we have before. Same schedule, same carb ratios, same snack. I just don't get it. The weirder thing is the numbers are pretty much IDENTICAL for the past three nights (for example, last night at 7:30 she was 331 and tonight at 7:30 she was 331... WEIRD).
As far as I've been told, Humalog starts to work in about 20 minutes, peaks around 2 hours, and is gone by hour 4. NPH (in most people, we've found differently with Elise), starts to work in 1 -3 hours, peaks by hours 4 - 9, and is gone in 14 - 20 hours.
So... anybody have any pearls of wisdom for us? We're going to try giving her a few more carbs for her bedtime snack to see what that does to her BG at around the 10:30 mark. Otherwise we're out of ideas.
I never should have opened my big "rock star" mouth.
Anyway... for the last three days, when we check Elise for her pre-bedtime snack, she's in the mid-300s. We give her a snack and her bedtime NPH, and usually somewhere between 9:30 and 11:00, she falls low. We give her some carbs and she rebounds into the 300s during the night, waking up in the mid-200s. The timeline looks like this:
5:00 pm - shot + dinner. Usual carb ratio.
7:30 pm - bedtime check. In the 300s.
Between 8:00 - 9:00 pm - bedtime snack (15g) and NPH.
Between 9:30 - 11:00 pm - Elise's BG is in the 70s. We give her carbs.
1:30 am - BG in the 300s.
Is it possible that her fast-acting insulin she gets at dinner (diluted Humalog) is peaking 4 - 5 hours after she gets her shot?
Is it the combination of her DH and NPH making her go low (are we giving the two shots too close together, which is approx 3 1/2 hours apart)?
Is the NPH now peaking earlier than it ever has?
Keep in mind, we are doing EVERYTHING the exact same as we have before. Same schedule, same carb ratios, same snack. I just don't get it. The weirder thing is the numbers are pretty much IDENTICAL for the past three nights (for example, last night at 7:30 she was 331 and tonight at 7:30 she was 331... WEIRD).
As far as I've been told, Humalog starts to work in about 20 minutes, peaks around 2 hours, and is gone by hour 4. NPH (in most people, we've found differently with Elise), starts to work in 1 -3 hours, peaks by hours 4 - 9, and is gone in 14 - 20 hours.
So... anybody have any pearls of wisdom for us? We're going to try giving her a few more carbs for her bedtime snack to see what that does to her BG at around the 10:30 mark. Otherwise we're out of ideas.
I never should have opened my big "rock star" mouth.
Subscribe to:
Posts (Atom)
