# Advice?



## hkk1970 (Oct 14, 2013)

Hi everyone, sorry its me again. I posted a while ago about Harry being higher in the night , and from your advice and our DSN we upped his basal but now we are all over the place, some nights he comes down too low and other times he is too high.  I just dont know what to do as every night is different, we are finding we are changing his basal and then it can go either way, no night is the same. I am exhausted because I cannot settle in the night as I dont know which way he is going to go.

Last night for instance he was 3.8 at 530pm, hypo treatment then went up to 7.8, by 10pm 5.3 so and by this morning he was 20 !!  Lunch time today he is 15.3 so have told the school to call me at 2pm if he has gone up so I can talk them through a correction.

I have come to the conclusion that we should stop adjusting his basal every few nights because its not getting us anywhere and wait till we have our appointment in November but is this the right thing to do.

thanks for listening.. Helen


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## novorapidboi26 (Oct 14, 2013)

I think until you can establish exactly whats going on with through the night tests, it probably isn't a good idea trying to chase the highs with basal changes.

Correcting with your bolus insulin should give quick, short term fixes to the highs, instead of risking the swinging highs and lows.

Its likely just a child's body being a child's body and so hopefully will settle down eventually....

Has there been any recent overnight basal tests done and if so what have they shown....?


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## Redkite (Oct 14, 2013)

Hi Helen,

Sounds like there's lots going on, ie growing, variable activity levels at school, etc.  I would be inclined to keep as many variables the same as you can for a while, e.g. regular mealtimes each day, and the same type of carbs each meal (e.g same cereal every day for breakfast, sandwiches for lunch - unless he's school dinners? - potatoes every day at tea), just to eliminate any issue from more tricky carbs like pasta etc.  Like you say, avoid frequent changes to his basals for now, just concentrate on keeping records and seeing whether there is any pattern (hypos mess up the pattern for the next few hours though).  Also, he is at an age where he is likely to pick up every bug going unfortunately, so another thing that can cause variability in the BGs is an illness brewing.  Life's not easy with little ones....


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## Hanmillmum (Oct 14, 2013)

Hi I agree with Redkite regarding trying to reduce the variables and in particular having some easy to digest teas that won't spike later. 
School is another new factor in the mix for us, already onto her second cold. It's afternoon that have gone a bit to pot atm and are taking some settling.


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## Pumper_Sue (Oct 14, 2013)

I'm wondering if his cannula is the wrong type for him.
I had major problems when one of the cannula types I was using decided it didn't suit me anymore. So I had samples from different manufactures and types of cannula to find what suited.


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## bev (Oct 14, 2013)

Hi Helen,

Growth growth and more growth! Alex is having a three week growth spurt which started at high teens and now is 13 through the night - he lives on correction doses and more testing through the night. In a week or so his levels will be back to 5's through the night so we dont worry so much now. I bet when you go to clinic Harry will have grown lots so try not to worry too much. If it were 20 for a month or more then this needs addressing - but it is common to have these sudden highs for growing spurts and it does settle after a few weeks. Sometimes it doesnt settle - thats when you know you need to up all the basals to compensate for the extra insulin needs - but you will learn when that is and how often to expect the growth hormones with practice!Bev


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## hkk1970 (Oct 16, 2013)

Hi, thanks for the advice, you were right, Harry had a bug and was sick everywhere Monday evening, levels at 20 keytone at 0.8 so had yet another sleepless night trying to bring him down. He is fine now, just same again, high in the night and now 3 days on trot hypos at 5.30 pm and one this morning.  

I just dont know what to do now , fortunatly he was at home today so mum spotted him goin gpale and tested and 3.5 but am not sure he would have told school , which is worrying.

I am at the end of my tether now, just had a cry in the toilets at work .

Do you think I should change his carb ratio at teatime now to stop the hypos at teatime?

Helen


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## bev (Oct 16, 2013)

Hi Helen,

I would delay bolusing for the food - do it either half way through or at the end - this is because absorption is affected after a sickness bug which will cause lows - its normal and happens with most people after a bug. Dont be upset - diabetes is really difficult to deal with - especially in little ones and your doing brilliantly so dont give yourself a hard time. Just be lead by the numbers - its not a judgement of your care - they are just letting you know that something different is needed for now.Bev


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## hkk1970 (Oct 16, 2013)

Hi Bev, thanks. He has had another hypo after dinner today. Mum had given his insulin after he had eaten all his lunch too. 

Dont really know what to do now, for the rest of his meals today.

He hasnt hypo'd in months , now weve had 2 today and 3 in past few days..

I try not to be too hard on myself but its not easy is it...

Helen


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## Redkite (Oct 16, 2013)

Tummy bugs are a pain with type 1!  For 2-3 weeks after the vomiting stops, there will be digestion problems as the gut is healing, so you will risk hypos after eating, and highs later on as the food absorbs.  With the pump, I would recommend bolusing for all meals with a square wave over 1hr, just to give the food chance to absorb.  You will inevitably have a rough ride for a couple of weeks though . After that, if he is still getting hypos all over the place, start by decreasing his basal until the hypos are eliminated (even if this results in some higher BGs to start with).  You need to get back to a baseline with no hypos, and then start working on each time zone in turn to bring levels back down to target.  But you can't do this until he's over the after-effects of the bug.


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## Cleo (Oct 16, 2013)

Just wanted to let you all know (Helen, redkite, bev and hanmillmum) that I think you all do the most amazing jobs with your children's diabetes.  I dont actually know HOW you do it but it really is very admirable, so well done to you all !!!! I am sure your kids will be so grateful when they are old enough to realize what you have all gone through for them.


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## Redkite (Oct 16, 2013)

You are very kind Cleo - I'm sure you'll be a wonderful Mum yourself!


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## hkk1970 (Oct 16, 2013)

Thank you Cleo. That's lovely of u to say so. I want to thank u all too as you have helped me hugely over this past week. Xx


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## Hanmillmum (Oct 16, 2013)

Cleo said:


> Just wanted to let you all know (Helen, redkite, bev and hanmillmum) that I think you all do the most amazing jobs with your children's diabetes.  I dont actually know HOW you do it but it really is very admirable, so well done to you all !!!! I am sure your kids will be so grateful when they are old enough to realize what you have all gone through for them.



Lovely of you to say Cleo, thanx. You will already be doing just what you can do for your little bump I bet, wait 'til they get here


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## bev (Oct 16, 2013)

Hi Cleo,

Aah what a lovely compliment! Whether we are parents or those with Type 1 - we're all in the same boat and all trying our best to deal with it all - so well done to you too and all those who fight this condition every day.Bev


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## Cleo (Oct 17, 2013)

Thanks so much to you all ! X


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