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Blinkin Heck

S

stoney

Well-Known Member
Messages
321
Location
South Wales
Type of diabetes
Parent
Treatment type
Pump
Why is it that James had a BG of 6.1 before lunch (5 units) to cover lunch at school yesterday and came home with a reading of 4.7

BUT today had a BG of 6.8 before lunch (5 units) to cover his lunch today, (should have been 6) but dropped a unit cos he had rugby last lesson and came home with a WHOPPING reading of 16.6 where did we go wrong :?: :?
 
Did he test before he played Rugby ? Anybody who does exercise needs to test before the event, during the event and after the event to see what exercise does to them. Everybody can react differently.

Exercise not only lowers Bg levels it can also RAISE levels....... :( Especially so if the level was high to start with. Anything around 13 mmol/l prior to the exercise and the levels can soar. That is also when a check should be made for Ketones. It is the usual advice NOT to exercise if the levels are that high. Food and/or Insulin intake may need adjustment.
 
Perhaps partly because his levels may not fall with that type of exercise and he had less insulin than normal so starting from a higher level. (did he test before starting?)
I had a look on the runsweet site which has a section on children and sport.

Not all forms of exercise are associated with hypoglycemia, and some patients frequently report hyperglycemia immediately after heavy exercise, probably because of an inability to secrete insulin to compensate for elevations in catecholamine levels . Indeed, intermittent high-intensity exercise, which reflects field and team sports, does not appear to increase the risk of hypoglycemia in patients with T1DM, probably because of increases in catecholamine levels.
Click to expand...
There are about 4 pages of info about what happens though I think that it is better at explaining strategies to avoid hypos rather rises.
http://www.runsweet.com/DifferentWithDiabetes.html
I have to say I don't envy you, trying to work it out. For one thing it must be impossible to predict just what type of exercise is going to be involved in any PE lesson, one week might include lots of short sharp drills, another week gentler but more sustained activity.
 
That's diabetes for you! Just when you think you've cracked it, it all goes pear shaped!

Others things might have been carbs miscalculated at lunch, or that when he gave himself his insulin he pulled the needle out too quickly and a large drop / drops came out. These drops can make all the difference. This does happen with my kids and we were told to make them count to 10 before removing the needle, but as with all children they are in a hurry to eat so they often rush it.

Might be worth checking the cartridge as well. We've had a day of unexpected highs only to find that the cartridge had a hair line crack in it so wasn't dispensing the insulin properly!

At least you spotted it early. I'm a stickler for blood testing my kids frequently to allow for correcting when high and trying to avoid those unexpected lows.

Hope there's an answer, but don't worry of you can't work it out.
 
hi

my dylan was always like that didnt matter what we did to stop it either, the nurse said it could be adrenalin raising the bgs we have not had the same problem since being on the pump however i think this is down to tighter control and being able to correct things so easily. hope u can sort it out soon

anna marie
 
Hi Everyone

An hour later and James has dropped to 6.1. It is not easy for James to test before games (Rugby) as he has only an hour to get to the changing room, change, get on the pitch, play, back to changing room and catch the bus home. His glucose meter is kept with the Nurse in her room (when she is there) and I would not want him to carry one with him as he has had his wallet gone missing before.

As he rings me everyday at the moment, I did instruct him to drop his insulin before lunch (as games is straight after) thinking that he might drop too low before he gets home :? I also know now that if he is above 13mmol/l he should not exercise, but if this happens everytime he plays, he will miss out on all the games

I think you are right Anna Marie, Its adrenalin, it must be I can't think of anything else it could be.

He also counts to 15 and not 10 when injecting as I had noticed a few drops after the count of 10

Life seemed so much easier on two injections per day :(
 
Adrenaline is usually released because of a low Bg level or stressful situations......this would then raise Bg levels. Did he feel hypo before the Rugby ? If not.....I doubt that it would have just been Adrenaline that was responsible for the rise. If he doesn't test as is advised you can only guess at the cause of the elevated levels.....?

What sort of food did he eat at lunchtime ?
 
My son Zac plays Ice hockey - it is a very energetic sport. When he trains he can go on the ice with a blood of 5/6 and will almost definitely come off 30 mins later with a blood sometimes over 20. There is achemical reason for this as I have read about it. We rarely correct the HI, as he can drop quite LO within 2 hours post training.
 
our nurse said because of the excitement and anticipation of the sport he was playing that adrenalin gets released and raises the bg, i took her word for it as couldnt explain the raised bgs

anna marie
 
Hi Cugila

OMG now dropped to 2.9 (treated hypo) but getting ready now to go football training!!!!!!!!!!!!!!

I have just asked him and he did not feel low before his rugby as he had not long finished his lunch which consisted of two Gluten Free sandwiches (20g carbs), Packet of crisps (20g carbs), 12 grapes, (10g carbs) curly wurly-snack size, (10g carbs) = 60 = 6 units (-1 cos I thought he might drop too low before he got home from school) H2O fruit shoot.

For his tea, he had chips (60g carbs), gammon,(NIL) sweetcorn (10g carbs) and home made gluten free pancake (20g carbs) = 90 = 9 units reading before food was 6.1

WHERE AM I GOING WRONG :cry:
 
sport can effect bgs hours after so u arnt doing anything wrong really its just he may need extra carbs or less insulin after, dylan drops a couple hours after sport so sometimes needs a biscuit just to keep him going.

dont beat urself up everything is a learning curve its like starting anew again u will get there just watch the patterns and adjust accordingly

anna marie
 
Anna marie.
I agree in some respects however, without knowing the pre match level it is all guesswork.

A level of 5-6 may be too low to start a high intensity exercise which could then drop lower and the person 'liver dump' which increases the Bg level. This may well be much higher and can then mean the Bg levels will start to increase with the exercise ? This could happen more than once depending on the time of the activity.....which is why when exercising it is important to know the start level, the midway level and the end level. Adjustments can then be made at that time and in the future to avoid the process happening and keep Bg levels at safer lower levels throughout the particular sport/exercise..

If the body doesn't have enough fuel to start with and levels are already low......then a 'Liver dump' is almost certain. If however the levels to start with are slightly higher then they will more than likely remain stable even with the exercise. A mid game/exercise check allows an adjustment to be made to keep the levels slightly higher but not too high. A snack or Sport drink maybe. That's why Rugby and football palyers have something in the half time intervals.....to avoid going too low and 'running out of steam.' A balance which takes practice.......but you do need to test to know what is going on. Everybody will react differently......

Just seen the other posts.......

That seems a large amount of carbs which will in itself contribute to raised Bg levels. We all know kids need to eat well but that amount plus less Insulin and the exercise have ALL contributed to the high post game levels. You really do need to try and get a balance considering all the variables, difficult I know. As the others have said it will all come together eventually. If he is off to training etc after the hypo keep a close eye on the levels as advised. Make sure he has his meter and fast acting carbs with him, plus plenty of water if the levels are higher.
 
Don't panic about it, this unfortunately is what happens with kids and trying to manage diabetes. In theory it sounds easy but in practice almost impossible. There are so many factors you have no control over which gives you a moving target.

What time did your son have tea? Could it be that he is still digesting food and the insulin is just acting a bit quicker than the digestion process. it also might be too much background insulin at this time of day? Although background insulin is supposed to offer a flatish profile it doesn't and the body's requirements alter so it can be difficult to get the dose right.

Just a few from suggestions to mull over!
 
oh right sorry cugila thought id been told wrong lol, yes a liver dump could make sense too its so hard to get levels right isnt it feels like a never ending battle we have fought for 4 years to get control with no reward until this year when using the pump dylan was 5.1 at breakfat and 5.9 at lunch its been fantastic.

i can completely understand how ur feeling stoney sounds like ur lad is like mine with loads of sport involved throughout the week we had running club and swimming today but some good levels maintained and altho yes the 2 injections a day are easier u get better control and reward for ur hard work with MDI

anna marie
 
I really feel sorry for anybody who has to go through the process of trying to get good control with Kids ......there are so many things to consider but I am sure with all the good advice from the Mom's and Dad's on here who have in many cases....been there, done that etc...... :)

Stoney......just take it all on board and change things a bit at a time, not all at once. Trial and error it may be.......it WILL work eventually.

ATB :wink:
 
I've just realised that your son has the same ratio for lunch and tea. A lot of diabetics including my kids need less insulin later on in the day. If he falls low after tea again, it might be worth altering the the ratio to may be 1 : 11 and see how that goes.

I racking my brains to come up with some reasons so I'm sorry if these ideas don't help!

Cugila is right, just make one change at a time as you will 'meet yourself coming back' !!!
 
I am so glad I have people to communicate with on here as I seem to living and breathing, testing, carb counting and injections. My DSN did also say that as James is a coeliac, his diet does tend to have more sugar content as well. I'm scratching my head with frustration as I type this.

Best better get off here now or they will be back from football training and have not moved from here since they left

Thanks again all
 
Feel for you!

I was going to suggestthat maybe he had some "juice" at half time...that may have had lots of carbs in it, or he had had an after match snack....butthe factthat his levels came down so quickly make me realise that this was not the case. If it is a tempory blip, then I guess he just has to ride it out...or get a pump? Might be worth asking? If you have already asked, then this is another reasone why he has an excellent case I would say.
 
When I was little, and on a very different regime to kids these days (this was the early 1980s), I didn't alter my insulin if I was going to be doing some exercise, I just had a snack beforehand.

Now that I'm on the new 4 a day regime (sorry, I don't understand the acronyms that you all use for things, is this what you mean by MD?) I still do that, so before a dance class I'll have a chocolate biscuit or something, which gives me a bit of extra sugar to replace all the carbs I sweat away during the class :D
 
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