Low carb for kids

[shivles]

She stayed with grandma and grandad Friday night so everything was a bit off Saturday day time, tea seemed to go well but we did dip a bit too low at 3am, this morning I put down to getting up an hour and a half later than she normally does.

If 1.5 units of levemir isn't enough but 2 is too much what do I do?

 

[catapillar]

If 1.5 units of levemir isn't enough but 2 is too much what do I do?

You won't like this answer, but you did ask. Look at a pump, where it is possible to titrate insulin by 0.05 units instead of the 0.50 units you are stuck with in a pen - it's a really big significant difference - and where, instead of having something that is trying to give you a flat basal rate, you can change the amount of basal according to how much is actually needed, hour by hour.

On MDI you could look at the timing of the levemir. Do you split it and give it twice a day? Maybe you could bring the basal earlier in the evening or even more towards lunch time. Levemir lasts about 12-16hs so if she is having one shot in the evening, it could be that it has run out by tea time and that is contributing to the evening hypers. You could split it and give 1u at night and 1u in the morning - you would have a period of overlap that might help with breakfast issues. Maybe have a chat with your healthcare team about the levemir?

 

[shivles]

You won't like this answer, but you did ask. Look at a pump, where it is possible to titrate insulin by 0.05 units instead of the 0.50 units you are stuck with in a pen - it's a really big significant difference - and where, instead of having something that is trying to give you a flat basal rate, you can change the amount of basal according to how much is actually needed, hour by hour.

On MDI you could look at the timing of the levemir. Do you split it and give it twice a day? Maybe you could bring the basal earlier in the evening or even more towards lunch time. Levemir lasts about 12-16hs so if she is having one shot in the evening, it could be that it has run out by tea time and that is contributing to the evening hypers. You could split it and give 1u at night and 1u in the morning - you would have a period of overlap that might help with breakfast issues. Maybe have a chat with your healthcare team about the levemir?

I've already stated we won't consider a pump at this point.

Split dosing we don't do, I will definitely mention to the team when I speak to them, they said to give it until Monday or Tuesday unless we have major issues

 

[azure]

If you don't want a pump, then split dosing would be the next thing to look at

 

[catapillar]

I've already stated we won't consider a pump at this point.

Split dosing we don't do, I will definitely mention to the team when I speak to them, they said to give it until Monday or Tuesday unless we have major issues

Sorry, I though it was worth mentioning just in case anyone else with similar issues was reading the thread.

Levemir is pretty good in that it is responsive to changes quite quickly, so the advice of give it 2-3 days and see how it goes is sensible. But I think nocturnal hypos should always be considered a major issue. Certainly that was the advice on DAFNE - make changes, give it a few days to see how it works, unless you are having overnight hypos. Maybe it's a bit different where you have a parent who is getting up at night to check, but you deserve some sleep too!

 

[shivles]

Sorry, I though it was worth mentioning just in case anyone else with similar issues was reading the thread.

Levemir is pretty good in that it is responsive to changes quite quickly, so the advice of give it 2-3 days and see how it goes is sensible. But I think nocturnal hypos should always be considered a major issue. Certainly that was the advice on DAFNE - make changes, give it a few days to see how it works, unless you are having overnight hypos. Maybe it's a bit different where you have a parent who is getting up at night to check, but you deserve some sleep too!

If it means her numbers are better through the day I don't mind at all! She was only just hypo too, 3.9, the other low was because we missed the usual breakfast time I feel. There was no bedtime snack last night as I wanted to see how the levemir worked on its own, I reckon a biscuit before bed might solve the issue

 

[Indy51]

@ shivles - just found another video on low carb for Type 1 children that you might find interesting: