can anyone help daughters blood sugars high

[sophsmam]

can anyone help im very worried with our daughters high blood sugars.I just don't know what to do her next appointment isn't till 3rd sept.We can't seem to get her bloods under control we increase her lantus but that isn't working.all the diabetic nurse says is to increase her lantus for the next 3 days then increase.she is 11 in february and only been dignosed since oct last year.She had great bloods to start off with.then they went high but found out she wasn't taking her lantus.But we just can't seem to get them down she is taking her lantus.they can range anywhere from 10 to 21 very rare they are below 10.I know she's going though puberty which won't be helping but what can we do to get them below 10.we are back to given her correction dosages after 2 hours which still doesn't help.
i will try and get to see the diabetic team before sept just at my wits end just worried about her.

 

[lionrampant]

At her age, you really need to be doing the injections with her to ensure accuracy - I was a few years older than her before I started doing my injections by myself. Independence is important, but so is getting everything sorted out to begin with. :|

Are you seeing a consultant or just the nurse and such in September?

Many diabetics (and doctors) consider Lantus to be a lemon of a drug. Is she on one single injection or two? Lantus can be unpredictable over a full 24 hour period and it's efficacy varies from one person to another.

Is she on any other insulin? (I'm not up to speed with modern "honeymoon period" treatment regimes.) Remember that at this stage even 2-unit changes in doses can make a difference so don't panic just yet. Keep following the nurse's advice, up the dose, check her sugars, and hopefully find the sweet spot.

Edit: what kind of diet is she on?

 

[sophsmam]

we do some of her injections but we always supervise her.she's just been on a trip with the diabetic team for 3 days her bloods were noted but never gave us any advice.
she is seeing the consultant and the nurse in sept.
she is on one injection of lantus which is 25 units.novorapid 3 times a day between 7 and 12 units depending on her blood sugars.
she eats a healthy diet just don't know what to do to bring them down.

 

[lionrampant]

Well I'm stumped because that all sounds exactly right for someone at her stage of type 1.

Can you list her blood sugars over those three days? Might help establish a pattern.

 

[sophsmam]

8.00 am 11.3
12pm 13.5
5.30 13.0
8.30 15.6


8.00am 11.0
12.00pm 10.4
5.45 16.5
9.00 13.5

8.30am 14.5
12.45pm 13.9
2.30pm 21.1 correction dose
5.30pm 12.7
8.30 10.4

these were from wed haven't done todays but she was 23 at teatime with 2 correction dosages thoughout the day.these high bloods have been going on for a while now.somedays she could have 1 or 2 good bloods a day but mostly high.

 

[yingal26]

I hate to suggest this but I know when I first became Diabetic (when I was 12) my Dad supervised my injections but I used to sneak naughty foods because I was trying to rebel against my new diagnosis and I was upset. Im also on Lantus and Novorapid and Ive been advised to try a different kind of insulin from Lantus too as many people have said it has problems. I hope you get it sorted soon but from my point of view give her the chance to do her injections herself and get her to record her readings, it will help her understand what works for her.

Best of luck.
Yingal26.

 

[sophsmam]

she never sneaks food she knows she cant she is a sensible girl where her diabetes is concerned. she does do her own injections but we do them if she asks us too.if i let her record her readings you'd never understand them lol.[Not a neat writer only when she wants too}.
we did try lemivar but that made her bloods be high on a morning which lantus is doing now.when she was first dignosed she was only on 15 units of lantus and now on 25.only 2 weeks back she was on 23 which on one morning she woke up in a hypo after about 6 days.so we gave her 22 but we've have had to increase it tonight to 25.

 

[yingal26]

Thats good! Sorry I had to ask its just I know what I was like at that age when I was newly diagnosed. I hope you get some answers soon.

Yingal26.x.

 

[sophsmam]

no worries she did in the early days but not now her high bloods worry her too.

 

[lionrampant]

Both Lantus and Levemir are know to have a more stable when split over two injections (morning and bed time). Some people don't need it, others do. Looking at your daughter's numbers it seems she's just not low enough to begin with for any of her injections to get to work. You might want to bring that up with the consultant. Also, I'm very surprised they took her off Levemir. Lantus isn't exactly the best fall-back position in the world.

As I said earlier, follow the nurse's advice and start increasing the Lantus.

If I may ask - how many carbohydrates does she eat at her meal times?

 

[fergus]

If I may ask - how many carbohydrates does she eat at her meal times?

That's the question! You say she eats a healthy diet Sophsmam, but whatever she's eating doesn't seem to be working for her.
Can you let us know what she eats on a typical day? There may well be big improvements on a different diet.

All the best,

fergus

 

[Jen&Khaleb]

I am a part of a reasonably sized juvenille diabetes group and many of the parents of teenagers have commented on having to give doses as high as nearly double to counter act the effects of hormones. My son is much younger than your daughter but can shoot up at the first sign of a cold. There are times that I need to be a bit heavy handed with the insulin and check him a couple of times to make sure he doesn't go low. Sometimes it is easier to get back into normal figures before the next meal. This can mean giving insulin a little ealier, delaying a meal or reducing the carb content to get on top again. I find Khaleb stays high for long periods if he is already out of range and then has a meal, even with a correction dose. Small meals, often, works for us. If you start with a decent figure it makes it a bit easier to work out the effects of food in the future.

Sadly, it is a lot of trial and error and kids are hard with their ever changing bodies. Your daughter is probably about to have a big growth spurt and this will also make her insulin requirements greater. Frustration seems to be a part of diabetes at times.

Wish you all the best getting the levels down but from what I've heard you are heading into a time that you may just have to ride out as best you can.

Jen Xx

 

[sophsmam]

on an average day breakfast bowl of cereal nothing that is sugar coated.snack a piece of fruit.
lunch maybe a salad with a jacket pototoe or pasta or sandwiches.low fat yoghurt or low fat jelly.
snack fruit or a low fat cereal bar or carrots and cucumber with low fat cheese.
tea usually something with salad or vegetables and her carb would be her pototoes.
with the dieticians advise chips and a small portion of sweets 2 or 3 times a week.usually chips once a week and sweets about twice with her tea.
we are back to carb counting to see if this helps today.she woke up with bloods of 12.7 and had 12 units which includes the correction dose when over ten.bowl of cereal with milk and a glass of milk.we are meant to check them after 2 hours. she checked them after 80 mins only because she'd had so much at breakfast,i was worried she was going to have a hypo they were 14.2.so in the next 40 minutes they need to come below ten which i don't think is possible but we will see.she will must likely need a correction dose.
yesterday morning she was 15.3 having had 24 lantus.so today 12.7 with having 25 lantus i know it takes 3 days.what usually happens is in a few days it is possible she will wake up to bloods being 4.1 so we would decrease the lantus but the following morning her bloods could be then 12 to 14.
2 weeks ago she woke up with bloods of 17 and the following morning a sudden drop to 5 and then the following morning they were 3.4.we can't seem to get them stable for whatever reason

 

[hanadr]

I'm a grandmother T2, who doesn't use insulin, but I have 30 years of experience with T1 in my husband. and working with other people
May I suggest your daughter would have lower sugars on a slightly different diet
How about scrambled eggs for breakfast? they only take about 1 minute 30 seconds in the microwave for 2 eggs.
For lunch, exchange the baked potato for a couple of tiny new pots. keep the portions of carbs to an absolute minimum.
I know growing kids may need some carbs, but it's far less than the Healthy Eating plate implies.
by cutting down on what the insulin works on, you avoid getting your daughter into the weight gain spiral. Also watch out for her interest in her appearance. It's not unknown for young girls to skip their insulin to get as thin as possible.( I know that's scary, but it happens.)

 

[sophsmam]

i do keep her carbs to a minimum when i say jacket pototoe its not a huge one. she doesn't like scrambled eggs or eggs that much.if she doesnt have a snack at mid morning she can be in a hypo by lunchtime.she does have quite a lot of hypos with high bloods.she had a bowl of pasta the other night and a low fat jelly within 90 minutes her bloods were 3.4 when they were about 12.but the following morning she's back to being high could it be possible its the lantus.

 

[janabelle]

Hi,
Bingo! The answer to your question is yes. Many people, including myself, find that Lantus doesn't work for them at all. I was having a few minor probs with my control while on Insulatard, and my hospital clinic switched me to Lantus-telling me it would solve all my problems and suggesting it was the best thing since sliced bread! However when I was having much more serious problems with Lantus, another change was never suggested. I had 4 1/2 years of lousy control and feeling like death.
Some days my blood sugar was high all day-on those days even my humalog didn't work effectively at lowering it. Other days I could go down to 2.4 without Humalog and on my usual Lantus dose!My clever husband thought, like you, that it was the Lantus-wish we'd suspected sooner.
If your daughter's doc is aware of how hap-hazard her control is,and not doing anything about it-perhaps you should change them too.
Best of luck
Jus

 

[suzi]

Hi Sophmam,
I have a son whos 11 in Nov and was diagnosed in Feb '06. I can pretty much guess how frustrating this feels for you both at the moment and how you feel youv'e explored every reason for her high bs and still drawn a blank. Carb counting isn't easy, especially when our kids are hitting puberty, i remember Andrew having pasta, gave him the correct units to carbs and within half an hour he had one of his worse hypos ever. Now we find with pasta half the dose works.
As for Lantus, we found that to be a complete nightmare, it just didn't work and the distress Andrew found using it as it stung so much, was a cause for concern. We recently changed to Levemir, and he's much happier, actually had to reduce the units compared to Lantus. We may think of splitting it come Sept as i reckon it runs out around 5pm. Unfortunately its a lot to do with trial and error, not what you want to hear, i know. Remember to count any glasses of milk when carb counting and certain fruits, something we sometimes forget. Check her keytones, especially when shes running high, and don't be scared to give correction doses in between ( though i wait at least 2hrs after last meal)
Feel free to PM me anytime, i've been where you are and know how hard it is,
Take care,
Suzi x

 

[suzi]

Opps almost forgot, make sure she is alternating injection sites, and that none of them are lumpy or bruised, as they all stop the insulin getting into the system and working properly.
Suzi x

 

[lionrampant]

Diet
I noticed you said you went back to carb counting! Sadly there's really no getting away from carb counting - it's not something you can use temporarily and then let slip. The dietician should have given you exact guidelines - i.e. how many carbs per meal, etc. Insulin is then balanced against that, and over time you learn how much alteration is required due to eating more or less.

It may seem difficult to follow at first but believe me when I tell you things are much easier nowadays than ten, fifteen years ago. There have been massive advances in terms of companies displaying nutritional info on food packaging. The majority of products display carbohydrates per portion/whole item and most even show you "of which sugars" - (this is the part you want even less of - regular carbs give a gradual linear rise in blood sugar, sugary carbs give a quick sharp rise).

Also don't fall for any **** you hear about "portions" and "G.I" diet metrics. There's only one way to measure how much food you're consuming (vis a vis insulin doses) and that's by counting the carbs consumed.

Short version: Count Carbs all the time.

Insulin
As has once again been pointed out, Lantus is pretty pathetic. It was great in theory, especially as a single dose agent; but in practice Levemir blows it out the water - especially with a split dose regime.

Also, if she's not too high (low enough to avoid ketoacidosis) and has enough insulin in her system a quick bit of exercise will also lower her levels.

Other

It's not unknown for young girls to skip their insulin to get as thin as possible

Yeah and it's not unknown for them to be upset about the bruising on their injection sites.

Finally, don't panic. Blood sugar levels are like any other variable in a system - learn what effects that variable and make gradual changes. Results will follow.

 

[sophsmam]

we only stopped carb counting when we found out she wasn't taken her lantus ,and the diabetic nurse told us to stop to give us a break and start when we were happy.
and now while she's on school holidays thought would be the ideal time to get back into it again.
when she went to marrick with the diabetic team where she was doing loads of excercise that still wasn't bringing her sugars down.when she was due to come home they left at 3pm her bloods were 21.they never gave us any advice in what to do ,we are new to this id like to know as much information as possible so i can ask the diabetic nurse could this be the problem.
we changed to disposable pens because it really hurt her and that was the reason she'd stopped taken it.her dad had read the disposable pens didnt hurt so much which they don't.May be a daft question could this be the cause they are solostar lantus.
sorry for keeping asking questions but all new to me.