Low carb for kids

azure

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Thanks I will bring those points up with the team.

It was 2hrs later

Ok - I assumed it was, but suddenly thought it best to check for sure : )

I usually hedge my bets, but here I'd bet on the insulin being the main issue, which is why you're finding it so frustrating.
 

shivles

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I'm not as crazy about it today, I got really overwhelmed by it all yesterday. Got appointment with the whole team next Friday so hopefully we will get a CGM and I can show them our problems.

I think what's happened is we dropped all her insulin a few weeks ago but now she needs to go back up but I've not a clue why that would be!
 
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azure

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I'm glad you're feeling a little better about it today :) Don't blame yourself at all. You can't succeed if her doses are wrong.

The honeymoon can mean erratic sugars. Your daughter's own insulin production will vary a lot, and remember she'll be going through growth spurts too.

Control is a work in progress, especially early on.
 
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Kristin251

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Just a thought. Food with a more fat tends to raise bgs over a slower time frame because the fat in the food slows down the absorbtion so if you give a full bolus with that type of food you may have a hypo followed by a steady rise in bg hours late. Just thinking about the eggy bread fried in butter? With injections I think you do this by splitting the bolus so you give some ar the beginning and some a while later. I've never done this so maybe others can offer advice on it. With a pump its called a square bolus. If my son has pizza I have to give his insulin bolus over 6 hours.
This is true. Fat and protein will slower and lower any spike but when you throw carbs in the meal it's a wild card. I cannot ear any carbs for BF. Later in the day I would still spike but not nearly as high.
 

himtoo

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Hi @shivles
I know this thread has gone a long way compared to many on the forum -- but perhaps this should tell you just how many people genuinely understand what you are going through , and want to help .
i think you are a lovely mother -- i would be proud to know you were my mother with your caring attitude.

perhaps you are looking at the micro detail so much that the bigger long term picture is taking a bit of a back seat ----- i was diagnosed many years before blood tests existed .............. so keeping to a routine was the best known way to help towards a long term future ....... I don't think that basic principle has changed - we just have more tools to help ( or confuse) in our goal to keep BG's as stable as possible
 

shivles

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85dac4e5f772db6f5d7b4f0bc9c70211.jpg


Last night's graph, after tea and overnight, fish fingers and sweetcorn is an issue too it seems.I've just give scrambled egg this morning and no insulin as she's in the 5s and I can't safely give it
 

catapillar

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I'm not sure it is the 16g of carbs that is the issue.

I think it's been covered that you should have a chat with the healthcare team about titrating the basal insulin up - it looks like she might need more overnight. She peaked and came back down after tea, but carried on climbing overnight. Suggests insufficient basal. I think. But have a chat with DSN about how to deal with the that if there were issues with hypos overnight previously. (FYI: The way a basal rate is bespoked on a pump could probably accommodate that a bit better than MDI)

Or looking at how she has come down by morning, it could be a timing of the basal issue, could be worth looking at splitting it,nor having it earlier in the day.

Then there's the bolus timing for tea, not sure when the bolus was in relation to the carbs, but bringing it forward a bit can help to soften the spikes.
 

shivles

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I'm not sure it is the 16g of carbs that is the issue.

I think it's been covered that you should have a chat with the healthcare team about titrating the basal insulin up - it looks like she might need more overnight. She peaked and came back down after tea, but carried on climbing overnight. Suggests insufficient basal. I think. But have a chat with DSN about how to deal with the that if there were issues with hypos overnight previously. (FYI: The way a basal rate is bespoked on a pump could probably accommodate that a bit better than MDI)

Or looking at how she has come down by morning, it could be a timing of the basal issue, could be worth looking at splitting it,nor having it earlier in the day.

Then there's the bolus timing for tea, not sure when the bolus was in relation to the carbs, but bringing it forward a bit can help to soften the spikes.
The thing is the team only ask for certain numbers, before meals after meals and midnight so they don't get this kind of picture! I am phoning them later so will bring it up.

I pre bolused 20 mins before as she was in the 9s, checked again just before eating and had dropped to the 6s so insulin had definitely kicked in
 

himtoo

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The thing is the team only ask for certain numbers, before meals after meals and midnight so they don't get this kind of picture! I am phoning them later so will bring it up.

I pre bolused 20 mins before as she was in the 9s, checked again just before eating and had dropped to the 6s so insulin had definitely kicked in
I am not sure what device you are showing us a picture of
( it looks like a smartphone app )
would you be able to create an account with Diasend
then you could upload all of the meter info to your account and your child's healthcare team should be able to access it( most hospital clinics have access codes for diasend ) - then you can both be viewing a full picture at the same time when discussing results on the phone

here is a link to diasend https://www.diasend.com/en/
this site supports the vast majority of meters on the market.
 

azure

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That won't be the fish fingers and sweetcorn. It definitely looks like a basal problem with possibly an adjustment also needed to the mealtime insulin (it's impossible to say for sure until the basal is at a correct level).

The results you're posting scream 'not enough insulin' to me.

Even if your team only ask for certain results, I would think the picture is clear enough.
 

shivles

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I am not sure what device you are showing us a picture of
( it looks like a smartphone app )
would you be able to create an account with Diasend
then you could upload all of the meter info to your account and your child's healthcare team should be able to access it( most hospital clinics have access codes for diasend ) - then you can both be viewing a full picture at the same time when discussing results on the phone

here is a link to diasend https://www.diasend.com/en/
this site supports the vast majority of meters on the market.

It's the mysugr app, I can email them all the reports. What I mean is that aren't really fussed about the numbers between the ones they ask for
 

shivles

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e93ff682de88c3b695c2323b878efc4d.jpg


Creeping up again but bit better overall, think not spiking at breakfast helped
 

CathP

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That looks like a much better day! It's so much easier if you start the day without a spike, otherwise you start on the roller coaster, and its really hard to get off. What did she have for breakfast today?
 

shivles

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Just scrambled egg, I had to give her a correction a couple of hours later but better than a 14+ reading after
 

shivles

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Did you manage to get any help from your daughter's team @shivles ?
I just spoke to them, they wanted to put the bosal up but I've asked to try upping the basal first so she's going up to 2 units of levemir but I've been warned to check her at 2/3 am which I'm presuming is the reason they were reluctant!
 

azure

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It's good that you've spoken to them and got some advice. Remember there's still the possible option of a split basal to try if this doesn't work, or even moving the time of the basal if it stays at one injection.

I hope she doesn't go low, but remember you still have plenty of options for adjusting her insulin. I know it must be very stressful indeed with the nighttime hypo worry, but if this adjustment doesn't work out then there's more to try.

It must be exhausting for you, but it does get easier once you have an insulin regime that works and suits your daughter. Hopefully, that will happen soon :)
 

himtoo

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that is a better looking day :)
glad you have some feedback from D team to up the basal
 
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Snootybutnice

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I just want to mention that I never gave my daughter any sweets when she was young - we lived in Spain at time and every lollipop that came her way I intercepted and said a nice thank you - with "I'll save it for her for later"(just to avoid people feeling embarrassed). We came back to the UK when she was around 2.5 years old and when she started school she gradually got access to sweets. For the first few years she didn't like them and claimed they were too sweet. When we went to a museum she opted for liquorice pontefract cakes as they didn't taste so sweet (although had as much sugar in them). She doesn't have diabetes but what I'm trying to say is that if your child is brought up without sweets, she probably won't really miss it that much until she gets to be 7 years old ish and then she may find herself under pressure of wanting to be the same as all of the other kids. I'm not sure if that helps at all!!
 

Kristin251

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I just want to mention that I never gave my daughter any sweets when she was young - we lived in Spain at time and every lollipop that came her way I intercepted and said a nice thank you - with "I'll save it for her for later"(just to avoid people feeling embarrassed). We came back to the UK when she was around 2.5 years old and when she started school she gradually got access to sweets. For the first few years she didn't like them and claimed they were too sweet. When we went to a museum she opted for liquorice pontefract cakes as they didn't taste so sweet (although had as much sugar in them). She doesn't have diabetes but what I'm trying to say is that if your child is brought up without sweets, she probably won't really miss it that much until she gets to be 7 years old ish and then she may find herself under pressure of wanting to be the same as all of the other kids. I'm not sure if that helps at all!!
I agree. We do t miss what we don't know and when the time comes a little bit or a few bites may be enough rather than the whole piece of cake

A person born blind has no idea what site is. So how can he miss what he doesn't know
 
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