# High Readings



## Adyc (Jul 7, 2010)

Hi,
I'm new here and joined as I would like to talk to others in a similar situation. My son was diagnosed with Type1 diabetes 2 years ago, which came as something of a shock. He has dealt with it and has self injected from day 1. Last week he had a check up and had lost 4 pounds, weight loss has been something he has been encouraged to do, he was so pleased,but speaking to the doctor he said that looking at his HbA1c, this loss was more due to bad diabetes management than diet or lifestyle change.
This has demoralised him, the doctor said we can either increase the insulin dosage, which would give increased weight gain, or he could moderate his intake which would allow the insulin he had to do more work. This doesn't seem to be happening and his readings just seem to spiral out of control.
The doctor we see is very understanding, and gives sound logical advice, I just seem to be the guy in the middle trying to help and do the best for my son. I don't expect a miracle post to cure all my son's problems, but would like to chat with others who can sympathise.


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## Copepod (Jul 7, 2010)

Welcome. I'm sure other member who are parents will be along soon to help, but they would probably ask the same questions as me: What age is your son? What things are important to him? eg sports / dance / acting / art / music etc.


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## Adyc (Jul 7, 2010)

Wow quick reply, he is 14, and this is part of the problem, he has no inclination to exercise. I have tried encouraging him with no success, I was about to look at the exercise threads for ideas. The trouble is, I can look as much as I want but it is him that has got to want to do it. We need to find something that he likes and enjoys. He is very into music, and art, and enjoys company, he loves being around people and although I am obviously biased, he is very likeable. The sort of youngster who can start a conversation with anyone.


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## Northerner (Jul 7, 2010)

Adyc said:


> Wow quick reply, he is 14, and this is part of the problem, he has no inclination to exercise. I have tried encouraging him with no success, I was about to look at the exercise threads for ideas. The trouble is, I can look as much as I want but it is him that has got to want to do it. We need to find something that he likes and enjoys.



Hi, welcome to the forum  I'm a little confused as to how your doctor attributes his weight loss problem to his HbA1c result. Is it high of low? A high one would suggest that he's not getting enough insulin for his food intake (carbs in particular) so may be suffering frome ketones frequently. What are his day to day levels like? Do you test for ketones? Sorry for all the questions, but it might help others to give you better advice.

As he is no doubt still growing at his age, it can be difficult to keep good control. Exercise would certainly help. What about walking - get him a pedometer so he can see how far he's doing each day - it might spark a competitive urge in him  Or how about a Wii Fit? They appear to be very popular and may be more attractive for him.


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## Adyc (Jul 7, 2010)

In his letter the doctor attributes the weight loss to poor diabetes control, his HbA1c was 11.5%. His day to day levels are generally in the mid teens, he does get below 10, but not as often as we would like. His reading this morning was 17.7, and he has a constant thirst, so we are trying t bring that down. I will take onboard the pedometer, he has got a Wii fit, so will have a look at that with him later. I am moving away to work and have a suspicion that this is causing him to comfort eat.


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## Northerner (Jul 7, 2010)

Adyc said:


> In his letter the doctor attributes the weight loss to poor diabetes control, his HbA1c was 11.5%. His day to day levels are generally in the mid teens, he does get below 10, but not as often as we would like. His reading this morning was 17.7, and he has a constant thirst, so we are trying t bring that down. I will take onboard the pedometer, he has got a Wii fit, so will have a look at that with him later. I am moving away to work and have a suspicion that this is causing him to comfort eat.



Certainly, this does suggest that he's not getting enough insulin. What sort of injection regime and insulin is he on? I hope you can find some way to encourage him to exercise - this really will make a huge difference to him. It will increase his insulin sensitivity, meaning he needs less (or can eat more of what he likes!), and also give him much better levels. The higher levels he is experiencing will be affecting his mood and making him feel even less enthusiastic - it is a vicious circle that he needs to break out of. As things stand, he may be doing himself harm in hidden ways, as the high levels will be potentially damaging to his blood vessels. 

I would recommend getting hold of a copy of Type 1 Diabetes in Children, Adolescents and Young Adults by Ragnar Hanas. It is full of useful information and might help your son understand more the importance and benefits of good control. Don't let him be disheartened by what the doctor has said - let's get him feeling positive and getting some satisfaction from getting those levels down so the next time the doctor has a smile on his face when he announces the results!


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## SacredHeart (Jul 7, 2010)

If he's into the Wii Fit, I've got a couple of good workout routines that I'm happy to share. Maybe of the parents on here with kids of a similar age might be able to get your kids in touch, if they've got a Wii, because each Wii has an 'ID number' which you can connect to others with, and compete


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## Adyc (Jul 7, 2010)

He is on Novorapid and Lantus, the Novarapid at breakfast,dinner, and tea the Lantus at supper time. You are right this does seem to be a viscous circle, thanks for all the help so far. I will look at getting the book.


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## Copepod (Jul 7, 2010)

Adyc - one sport that might appeal to him, particularly if he likes maps, associated with art, is orienteering - both competing and map making. I didn't have diabetes, nor had even heard of orienteering as a teenager, but did enjoy art, technical drawing etc, and loved surveying a map on a BSES Expedition to East Greenland as a 17 year old - an activity offered most years on current BSES Expeditions to arctic & tropical regions. As he's 14, he's got time to build up the experience in hills, walking, navigation etc that could lead to a 1 month expedition under canvas or using hammocks when he's 16 - 20 years old. Orienteering generally needs help with transport, as main events tend to be on winter Sundays, when there's less public transport and sometimes too far to cycle, although there are permanent courses that can be accessed any time, and there are summer weekend daytime and weekday evening events, which are often in town parks etc. 
By the way, when I was diagnosed as a 30 year adult woman, the most useful thing was the memory of a young man, then aged 17 years, with diabetes, who was a member of a "fire" (BSES Expedition group) I led in South Greenland in my late 20 years.
If any of these ideas appeal, you (or your son) should be able to find them via a search engine, but if you want URLs, then please PM me.


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## Adyc (Jul 7, 2010)

Thanks, 
I will have a look at that, I am that way inclined, I did my Duke of Edinburgh to gold award, and still love the hills. George does come with me sometimes and we do enjoy the outdoors so it may be an avenue to explore. It is helping being able to get some feedback and some ways to progress.


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## Northerner (Jul 7, 2010)

Adyc said:


> He is on Novorapid and Lantus, the Novarapid at breakfast,dinner, and tea the Lantus at supper time. You are right this does seem to be a viscous circle, thanks for all the help so far. I will look at getting the book.



One thing that might be worth looking at is his Lantus. If his levels are on the high side pre-meal, then it may be that the lantus dose is too low, so you could ask the doctor about that and that might improve things a lot  Does he carb count - matching his novorapid to his carbohydrate intake, or is he on fixed doses precribed by the doctor?


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## bev (Jul 7, 2010)

Adyc said:


> Hi,
> I'm new here and joined as I would like to talk to others in a similar situation. My son was diagnosed with Type1 diabetes 2 years ago, which came as something of a shock. He has dealt with it and has self injected from day 1. Last week he had a check up and had lost 4 pounds, weight loss has been something he has been encouraged to do, he was so pleased,but speaking to the doctor he said that looking at his HbA1c, this loss was more due to bad diabetes management than diet or lifestyle change.
> This has demoralised him, the doctor said we can either increase the insulin dosage, which would give increased weight gain, or he could moderate his intake which would allow the insulin he had to do more work. This doesn't seem to be happening and his readings just seem to spiral out of control.
> The doctor we see is very understanding, and gives sound logical advice, I just seem to be the guy in the middle trying to help and do the best for my son. I don't expect a miracle post to cure all my son's problems, but would like to chat with others who can sympathise.



Hi, my son is 12 and was diagnosed nearly 2 years ago. He is on an insulin pump and his control has improved dramatically. His hba1c has dropped from 9.6 to 7.1 in a few months.

I think its awful that the doctor has knocked your sons confidence in this way. He is at a very vulnerable age and needs encouragement and support - not to feel demoralised!

From reading your other post saying the hba1c is 11% - this will be making your son feel dreadful - no energy and no motivation - so what does the doctor expect? If you have no energy - you dont want to exercise - so what the doctor *should* be doing is helping to get those very high levels down to enable your son to firstly feel better, and secondly, to enable him to *feel* like doing exercise.

Does your son often have ketones? If he is thirsty then this is a sign of ketones which as you know isnt good. I would be asking the doctor for advice on how to lower levels in a safe way without hitting hypo's all the time.

Do you do basal testing? Are his basals right? If they are right then you need to be looking at the ratios and correction factors. There is always a reason for high levels - but the problem is getting to the bottom of what it is!Bev


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## Adyc (Jul 7, 2010)

I have had to keep him off school today, his readings are so high, hopefully coming down now. Ketones are fine, Basal readings is a new world to me, I will have to look up on the net further.
You are right with the viscous circle thing, he does not feel like exercise at all. I will ry t sort this blip out and then encourage him to exercise more.


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## Adyc (Jul 7, 2010)

The Wii fit is a good idea, and is now back in operation, he has brightened up a lot, so I will get him on the move a bit. I want to try to avoid it being me pushing him all the time, and him doing it as he wants to.


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## bev (Jul 7, 2010)

Adyc said:


> I have had to keep him off school today, his readings are so high, hopefully coming down now. Ketones are fine, Basal readings is a new world to me, I will have to look up on the net further.
> You are right with the viscous circle thing, he does not feel like exercise at all. I will ry t sort this blip out and then encourage him to exercise more.



Hi,
The basal is his background insulin and the bolus is the fast acting insulin that he has with food.
If you have your basal right then in theory he could go 24 hoours without food or fast acting insulin. 
Do you know how much insulin brings him down 1 mmol? Have you been taught corrections? 
If he is doing exercise then he shouldnt really be doing it if he is over 15mmols as this can send him even higher if he doesnt have enough insulin on board.
If you want to post a days readings on here I am happy to help see if there is a glaringly obvious problem. Sometimes when you see the same numbers every day its hard to work out what the problem is and it takes a third party to see it!Bev


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## Adyc (Jul 8, 2010)

Thanks for the offer Bev, I will track his readings today and post them later.


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## gewatts (Jul 8, 2010)

Hi.  I agree with Bev - it does look like you might need to tweak how much insulin he has. As for exercise - have you ever heard of Geocaching? Check it out - www.geocaching.com  - basically it a bit like a treasure hunt. People hide "caches" (normally a tupperware box filled with goodies and a log book or just a log book if it's a small one) and log the co-ordinates on the website. Other people then go (armed with a GPS system) and find it, sign the log book and swap treasure. It adds a new dimension to going out for a walk. We love it - it can become very addictive!!


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## Adyc (Jul 9, 2010)

I must confess I was somewhat sceptical about geocaching however, I just searched the site and there are a whole series within half a mile of me. What George will make of it I don't know, but I think he will like it, I was given a present recently of a handheld satnav, so I will have a dabble later.Thanks for the info, as I had not heard of this before.


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## Copepod (Jul 9, 2010)

I'd second the idea of geocaching, whether on foot, bike, kayak etc - have done a few alone, with partner, his dad, my mum & dad, sister, nieces etc - age range from 5 to 75! However, do check that your hand held sat nav is suitable - you need to be able to get within about 10m of destination; start with easy caches and always print out the clue, even if you don't use it unless you need it; take a digital camera to record sites; make sure each person chooses a user name, so you can each log a find, regardless os which combination of you find each one. Not sure if Bev and A took up the suggestion of geocaching some months ago?


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## Adyc (Jul 10, 2010)

The geocaching intrigued me, didn't find the cache, just a multitude of nettles and gorse, but have more of an idea now.


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## Copepod (Jul 10, 2010)

Should have added advice to wear nettle and thorn proof trousers for summer geocaching. Actually, it's easier all round in winter, with no leaves on deciduous trees to block out GPS signal; nettles, brambles, bracken etc die back. Gorse doesn't go away, sorry...


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## gewatts (Jul 11, 2010)

Also - gloves are a must for searching in the undergrowth!! And don't forget a pen!


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## Pigeon (Jul 12, 2010)

I find the easiest way to exercise is to try to build it into your day - can he walk or cycle to school, to the shops etc?

Another exercise that I do is trampolining - I go to a class at the local leisure centre and lots of teenagers go. I don't know if that might appeal as it is more fun than your typical sports.


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## Andy HB (Jul 13, 2010)

Pigeon said:


> I find the easiest way to exercise is to try to build it into your day - can he walk or cycle to school, to the shops etc?
> 
> Another exercise that I do is trampolining - I go to a class at the local leisure centre and lots of teenagers go. I don't know if that might appeal as it is more fun than your typical sports.



Isn't trampolining to school a little dangerous, not to mention impractical? 

Andy


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## Patricia (Jul 13, 2010)

Hiya

My son is 14, diagnosed for 19 months now, and on a pump. We are fortunate in that partly due to the pump we've managed to help him to a good HbA1c.

But that's not what I want to say! What I want to say is that I can relate to the no exercise thing. My son doesn't need to lose weight, but is often if not always completely uninspired to exercise, despite (or maybe because of?) the rest of us doing it. We have found two things:

1) football in the garden. He will sometimes do this with his sister or father for an hour or more. A new development. No rules, penalty shots only! Good fun.

2) bribery. We have made a deal that if he runs with his father three times over consecutive weekends, he will receive ?15. This is a one-off, so he gives running a chance. Some of his problem is that he doesn't 'fancy it' so doesn't give it a try. We may well go on to try other things with him in a similar way, in the hopes of finding something he likes.

***

Re your son's high readings... I'm so sorry to hear this. It's so hard on all of you. My son's levels are FREQUENTLY all over the place,and so hard to predict it's infuriating. But it does sound as if your baseline insulin amounts need looking at, so that you are starting from a more stable point in order to then deal with his adolescent irregular levels without such catastrophic results.

I would *strongly* advise against reducing your son's calorie intake unless he eats junk etc -- in which case I'd encourage good food. Kids need calories to grow! My son eats ALL THE TIME, and is growing like a beanpole. This is natural and should be encouraged! 

So I guess I'm really agreeing with everyone here, but from the point of view of a parent of a same age teen: look at the basal (Lantus) level first. Post your blood sugar readings here if you like, to get a start. But I would think that at least the lantus needs to go up, so start there. Once you can get a decent morning level (not every morning -- we find that my son's levels in the morning vary HUGELY because of growth hormones -- but generally), then adjust the novorapid.

Keep coming here. We'll help. 

Do you have a good DSN? Sometimes (ahem) the doctors are really not the best ones to help you.

Good luck and I look forward to hearing how things are going.

Patricia


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## Adyc (Jul 18, 2010)

Sorry for not posting for a while, I have moved away to work (and am not sure how this will affect George's readings). His readings do seem to have settled down, although sometimes can be on the high side. I have not seen that much of his DSN, the upside of moving is that they do diabetic clinics which will hopefully help. It is difficult to do things from a distance but I will try to get him more active, I do not normally subscribe to bribery but in this case may have to. Thanks for your advice and support, it's nice to get this from somebody in a similar situation.


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## Copepod (Jul 18, 2010)

*"bribery" for running*

Just to add that Parkruns offer a "bribe" T shirt to juniors for 10 runs (don't need to be consecutive nor at same location); adults have to do 50 runs to get a T shirt.


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