# Cannot get levels down



## MeanMom (Sep 9, 2010)

I am getting really frustrated at the moment as my daughter has had hardly any readings below 10 for some weeks now - thought it was the summer holidays doing it but the same is happening now she is back at school. Last evening she had a meal that i worked out has only about 65g of carbs but as her b/s had been around 14 all day we decided to give her 15 units of Novarapid. Two hours later at bedtime (after her usual snack of 100ml of mik and one 7g  biscuit) and her bs was about 12. She was around 8 when she got up this morning but i think her levemir is still working then. She has 15 units of levemir a night. 
She is just coming up to her six months since dx but we do not think she is honymooning. She weighs about 45 kilos and is about 145cm tall. How much is too much insulin?
If anyone has any ideas where I am going wrong please pass them on. Thanks


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## novorapidboi26 (Sep 9, 2010)

You can never have too much insulin, well you can, but whatever you need to get the sugars down is my moto.........

Its hard to offer any effective advice without knowing ratios and so on but I would just strip it back to start and make sure your novorapid ratios are right........as children grow there requirements change more often than the adults


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## MeanMom (Sep 9, 2010)

the ratio last night for the meal mentioned was 1:5 plus 2 corrections as her bs reading was about 14. Should i have used more corrections? When we had our carb counting course the dietitian said sometimes teenage boys need to use a ratio of 'as much as 1 : 5 ' which I took to mean that is the most you could expect anyone to use and my D is only 11?


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## Robster65 (Sep 9, 2010)

Could it be stress affecing her ?

If she's 11, has she gone up to senior school with all that involves ?

Apart from that, I agree completely with novo'boi. Everyone has different needs despite the rules some dieticians suggest. 

Rob


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## bev (Sep 9, 2010)

You give whatever amount the body needs - so there is no *right* amount - and its different for everyone. I would say that your daughter is probably displaying hormone changes and growth. The levels are just data that is telling you that she needs more background or more with each meal.

I would suggest you do some basal testing over the weekend to see whether the basals are right. If not, you might need to split the levemir as it does run out before the 24 hour mark which could be adding to the problem. If the basals are ok - then you need to look at all the ratios. It is just a game of finding out where the problem lies and when you do you will be able to act on it. If it is hormones then perhaps you need to consider a pump as they are really good at sorting hormones out. My son (12) has been on a pump for nearly 1 year now and we find it is much better than injections.Bev


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## Monica (Sep 10, 2010)

Just to tell you 1.5 is not the maximum!

C has 2u per 10g of carbs for breakfast and 1.5u for everything else. But I have a question. When your daughter is having her bedtime snack, do you give her insulin for it? I've been told C (13) doesn't need bedtime snack anymore now she's on Rapid and Levemir. If she does have something over 10g, she has insulin for it. Also, C is on 20u of Levemir. Like Bev said she might have a growth spurt and her hormones starting up, which means she will need more insulin to cope with that aspect of growing up. If she's high all the time, she needs more insulin.

Anyway, don't feel you're going wrong. Diabetes is unpredictable at best of times and what was ok yesterday, might not be ok today.


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## MeanMom (Sep 10, 2010)

Thanks everyone 

Monica - we dont give insulin with her bedtime snack as we do not give insulin for a snack of 15g or less (K has one 15g snack mid morning, one mid afternoon and one for supper) I thought this was OK? I dont think she needs a snack at bedtime but all her life she has has milk and a biscuit for supper and it has been something from her 'old life' she wanted to carry on with. 

Bev - what do you mean by basal testing?  I didnt think the levemir lasted 24 hours, only about 12? I feel like there are some big gaps in my knowledge. 

By the way this morning her bs was around 5 when she got up


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## Monica (Sep 10, 2010)

carolynsurry said:


> Thanks everyone
> 
> Monica - we dont give insulin with her bedtime snack as we do not give insulin for a snack of 15g or less (Katie has one 15g snack mid morning, one mid afternoon and one for supper) I thought this was OK? I dont think she needs a snack at bedtime but all her life she has has milk and a biscuit for supper and it has been something from her 'old life' she wanted to carry on with.
> :



Well that surprised me even more that Katie still has her mid morning and mid afternoon snacks. C stopped having her snacks, as soon as she went on MDI, although I found out that she eats her lunch crisps at 11am, simply because she's hungry and I guess lots of her friends eat something then too. But she then includes the crisps in her lunch insulin. C is very happy not to have to have the snacks anymore.

C does have bedtime snacks occasionally, usually it's a handful of dry roasted peanuts, but if she's hungry she'll have more and will inject for it. 

But everyone is different, and if this works for Katie, don't change it.


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