Losing control? Type 1 child.

Opossum

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Hi, my daughter (5yr) was diagnosed 5 months ago and doctor said she is in honeymoon period and therefore proposed treatment with humulin r + humulin n in the morning and evening. Doses are small (as I understand): 0,5u/1u/1,5u/3,5u. We generally did not change that since bg control was fine and hba1c was 6,1 on three months control. Recently things are going out of control (or I think so): every day she has readings of over 11 mostly after lunch or in the evening. She also tends to go to hypo before lunch (not everyday). I called her doctor being more worried about everyday readings of above 11 but she advised to reduce insulin leading to pre-lunch hypos and it might normalise after-lunch readings.

My questions:
1) are readings of above 11 once per day alarming? It is not constant hyper but it is everyday
2) does it make sense that avoiding hypo can help avoid hyper?
3) are these signs of honeymoon ending or since she is not getting large amounts of units this is still honeymoon?

Thank you for replying on my first post.
 

urbanracer

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Hi @Opossum , and welcome to the forums.

1) Many would suggest being at 11 every day is not good. It certainly isn't helping her a1c average.

2) It is not easy to correct a hypo accurately. You take a lot of glucose on board to stop yourself collapsing and half an hour later you're hyper. So in a sense yes, maybe.

3) The honeymoon period can be erratic for some so it's difficult to say if it's ending.

Have there been any changes to diet or activity levels. Is she just starting school holiday and changing lifestyle?
 

Opossum

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Thanks @urbanracer. It is s fact that these numbers coincide with her leaving kindergarten for holidays. And since we live in southeast Europe, this summer is extremely hot so she is not so active in the afternoon therefore those might be the reasons.
I just rarely have a chance to see other people's readings (it is not often discussed) and as a newbie I needed to verify.

@noblehead, thank you for the link, I'll check it out although not being UK citizen majority will not apply.
 

noblehead

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Wherever you live @Opossum do see if there's a Specialist Paediatric Clinic at a hospital near you.
 

urbanracer

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Thanks @urbanracer. It is s fact that these numbers coincide with her leaving kindergarten for holidays. And since we live in southeast Europe, this summer is extremely hot so she is not so active in the afternoon therefore those might be the reasons.
I just rarely have a chance to see other people's readings (it is not often discussed) and as a newbie I needed to verify.

@noblehead, thank you for the link, I'll check it out although not being UK citizen majority will not apply.

I recently found out to my own cost and was advised by @noblehead ( and a few others) that high temperatures can help to speed up insulin absorption so the heat might be a contributing factor.
 
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Opossum

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Sure there is. When I mentioned doctor I meant pediatric diabetologist. Therefore she is in the system and she is controlled regularly. Only now being on holiday we were left on phone support and I was not pleased with latest advice I got.
 

Jaylee

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Hi, welcome.

I was a T1 child of the 1970s, so may not be of any help to you. Through the regime your little girl is currently on don't sound dissimilar to me back in the day, from your description...

These are my thoughts. Trying to think back many many years......
To Q1. Sounds like something not quite right in her constant daily routine regarding carb count or diet attributing to a certain point in the day..?
To Q2. Over treating any hypo can & will swing it the other way, resulting in a high.
To Q3? The honeymoon will end when it's over.. The doses prescribed are adulterated by the "swan song" of you daughter pancreas before it finally gives up causing these inconsistencies... (Though to my mind they seem consistent by you description.)

Constant testing is key.. Bear in mind due to the nature of blood flow/circulation there is a "lag" in the result given by the blood meter. So a low if treated already may take time to show a rise even if the meter is saying the blood is still low? Think of the meter reading as a "snapshot" of upto 15 minutes ago... So don't panic if you test her every 30 seconds & she still seems low..?

Reading your recent post. Heat can increase insulin sensitivity regarding the variable thrown in the mix....
 

noblehead

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Sure there is. When I mentioned doctor I meant pediatric diabetologist. Therefore she is in the system and she is controlled regularly. Only now being on holiday we were left on phone support and I was not pleased with latest advice I got.


You can still contact the clinic and your daughters team will advise you over the phone, ring them tomorrow.
 

donnellysdogs

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To manage better you really need to ask your consultant to go on dafne course to enable and empower you to manage your daughters diabetes and insulin adjustments as needed...