Advice needed

AnneK

Active Member
Messages
28
I have been trying to contact my Sons nurse all day to no avail and our medical centre kept telling me you need to keep trying she is the best person to talk to wherever i phoned to get them to let me talk to someone...

Reece was diagnoised in April this year and so far we have done a pretty good job managing things. As we are currently based in Germany we work on different readings to UK so between 60 and 160 is what the hospital advised up to keep Reeces levels between. At bedtime i always ensure that his levels are at least 150 and that has been ok up til now. All this week he has been going to bed at atleast 150 but when he wakes up every morning his BS are reading 200.... What could be causing this? This morning he was slightly high at almost 300 (however he had gone to bed at 230)

We are not back to the hospital until 17th Novemeber and i will discuss this with them (although the language barrier makes it difficult sometimes) However if i can try reslove this myself i'd like to try as i don't want hi to keep waking up higher than before he went to bed....

I'm still trying to get to grips with all this so any help and advice would be appreciated

Anne
 

Debloubed

Well-Known Member
Messages
828
Type of diabetes
Type 1
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Pump
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When people say 'Pacific' instead of 'Specific' :-)
Hi Anne,

Wow, sounds a bit perplexing, different system and different language! as far as I know, you divde the 150 by 18 to get UK mmol measurements so that would mean 150 = 8.3. Please check this though!! As for your son going high after a normal BG reading at bedtime, is he on a long acting bedtime dose? Or perhaps his evening meal consists of too many long acting carbs? I understand your frustration but the best place to go with your findings is your Doc or DN - good luck!

Hope you manage to sort it out :D
 

fergus

Well-Known Member
Messages
1,439
Type of diabetes
Type 1
Hi Anne,

A few quick points first of all. The range of acceptable blood glucose readings where you are is wider than in the UK. Here, the NHS recommends diabetics try to remain between around 70 -130.
Having said that, the ideal level to aim for is around 90 as that is a typically healthy non-diabetic reading.
Your son's bedtime reading is above 150 (8.3 in UK money) and that's really too high on a regular basis. 200-300 (11.1 - 16.6) is much too high, high enough in fact to cause damage to much of the body.
As your son was diagnosed in April and his bg levels are now creeping upwards, this suggests he is coming to the end of what's known as the 'honeymoon period'. This is a time when the pancreas still has some remaining insulin producing capability, but can quickly be ended when bg levels are routinely too high. It's a dificult time and you'll need to be vigilant in monitoring his levels and adjusting his medication levels upwards to suit.
The other option is to have a close look at his diet and remove the foods which cause his blood glucose to rise so high. This can have a significant impact both on reducing average bg levels and also reducing the fluctuations between low and high.
I hope that helps, but please keep us posted.

All the best,

fergus
 

Debloubed

Well-Known Member
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828
Type of diabetes
Type 1
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Pump
Dislikes
When people say 'Pacific' instead of 'Specific' :-)

cugila

Master
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People who are touchy.......feign indignation at the slightest thing. Hypocrites, bullies and cowards.
I think so too. It would help us all to help anybody who posts using non UK numbers to do the conversion first then post the numbers. Avoid such confusion if we can. Thanks. :D

Divide mg/dl by 18 to give mmol/l. Vice versa for other way round.
 

Debloubed

Well-Known Member
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When people say 'Pacific' instead of 'Specific' :-)

phoenix

Expert
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5,671
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Type 1
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I'm sorry that you're having problems, as has been said it may be that the honeymoon is coming to an end and that you will need some help from your team to adjust the insulin dosage.
I do hope that you managed to get on to them as levels 200 and 300mg/dl (11-160mmol) are too high and need to be dealt with fairly quickly.
Children are very different to adults which is why I hoped someone with some experience would have replied.
After Fergus's post, I checked the NICE guidelines for children in the UK, they were as I thought, higher than for adults.
Children and young people with type 1 diabetes and their families should be informed that the optimal targets for short-term glycaemic control are a pre-prandial blood glucose level of 4–8 mmol/litre (72/144 mg/dl) and a post-prandial blood glucose level of less than 10 mmol/litre (180mg/dl)
http://www.nice.org.uk/nicemedia/pdf/CG015NICEguideline.pdf
Elsewhere, leaflets issued by various paediatric depts seem to say that at bedtime levels should be between 7mmol and 10mmol (126-180mg/dl) and that a bedtime snack needs to be considered. (depending on prior activity and insulin type)
http://www.nnuh.nhs.uk/docs\leaflets\499.pdf

Hope, that you've managed contact now.
 

africandoll

Member
Messages
12
Another reason could be that he might be having hypos during the night and not feeling them,so try doing some checks in the night to see whats happening there.
Good luck