Hypo every night!

[eshobabu]

I have a 6 yr old daughter diagnosed with type 1 3 weeks ago. We started with 6 units of basal at night. We went to 5, 4, and now to 3. Still, she is going hypo every night. Should we go down to 2? 1? 0? on the basal? The problem is she spikes a LOT after meals. So like she will go from 70 to 300 with a banana. So we need to probably bump up the Humalog. I have an appt with the endo next week, so i'll run this by her but wanted to get other folks who have been through this and how to handle :-(

 

[DCUKMod]

I have a 6 yr old daughter diagnosed with type 1 3 weeks ago. We started with 6 units of basal at night. We went to 5, 4, and now to 3. Still, she is going hypo every night. Should we go down to 2? 1? 0? on the basal? The problem is she spikes a LOT after meals. So like she will go from 70 to 300 with a banana. So we need to probably bump up the Humalog. I have an appt with the endo next week, so i'll run this by her but wanted to get other folks who have been through this and how to handle :-(

Eshobula - I'm not an insulin user, but I do think you should be getting this sort of information from a professional looking after your daughter.

It seems likely your daughter probably need a little less insulin, if this is a regular thing. Maybe she's having a bit of a honeymoon period, but really nobody here can advise you on adjusting your daughter's medication.

Please do give your team a call.

 

[MarkMunday]

The general rule is to reduce basal when there are hypos between meals and use as much bolus as is required to get blood glucose back down into the target range after spiking. Insulin requirements change after the initial use of injected insulin. It is not unusual for remission to look like the diabetes has gone away, for a while at least. Be guided by response to previous dosages, but wait until there is a definite pattern before making changes.

 

[ert]

I hope your diabetes consultants respond to you soon. They tend to start you on a bolus which you have to titrate up or down. I started on 2 units at night. Sometimes I take 1 unit or I go too low overnight You will get it sorted with your specialist's help and advice.

It's usual to spike after eating, it's the nature of the fixed cured insulin you're injecting and doesn't act like a normal person's insulin, (and not related to needing more bolus); as long as blood sugars come back down 4 to 5 hours after eating to what they were pre-meal you've done well.

 

[Daibell]

Hi. I would be careful anyway with the bananas as they are very high in sugars; keep the banana size down and try to avoid tropical fruit where you can. Bananas would need a higher Bolus dose

 

[eshobabu]

Ok so had a long chat with the endo today. What they are suggesting is that the basal needs to be adjusted down until what she sleeps at and what she wakes up at is max apart 30-50. So IF she goes to bed at 150, she should wake up between 100 and 200. Until that adjust the basal all the way down to 0 if needed.

Obviously, with changing the basal she might need to adjust the bolus, but that remains to be seen. All indications point to a honeymoon enter phase, fingers crossed it lasts for a very very long time.

 

[MarkMunday]

Sounds like good advice. Be aware that as she is newly diagnosed, the insulin requirement could increase again quite quickly. Monitoring tests and titrating dosage becomes an ongoing process.

 

[eshobabu]

Sounds like good advice. Be aware that as she is newly diagnosed, the insulin requirement could increase again quite quickly. Monitoring tests and titrating dosage becomes an ongoing process.

Yep - watching her dexcom like a hawk.

 

[TypeZero.]

I have a 6 yr old daughter diagnosed with type 1 3 weeks ago. We started with 6 units of basal at night. We went to 5, 4, and now to 3. Still, she is going hypo every night. Should we go down to 2? 1? 0? on the basal? The problem is she spikes a LOT after meals. So like she will go from 70 to 300 with a banana. So we need to probably bump up the Humalog. I have an appt with the endo next week, so i'll run this by her but wanted to get other folks who have been through this and how to handle :-(

Definitely call the diabetes hotline to ask for advice. I’m not a professional but it sounds like the basal may need toning down and the insulin to carb ratio may need to be changed. That’s what it sounds to me like anyways

 

[eshobabu]

Definitely call the diabetes hotline to ask for advice. I’m not a professional but it sounds like the basal may need toning down and the insulin to carb ratio may need to be changed. That’s what it sounds to me like anyways

This is exactly what the endo did. We are now basal 0, insulin carb ration 60. So we only give her insulin for LARGE meals. She is in honeymoon so she went 3 days with no basal, no humalog. But today we went out to celebrate and she spiked up to 360 - probably because we underestimated the carbs from restaurant food. We gave her 0.5 units as soon as we saw her climb past 200. Within a few hours she was back down to 120, and now fast asleep hovering around 160 after no insulin dinner of boring old 30 carb home food .