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control is tricky

M

Matt1212

Well-Known Member
Messages
75
Hello All,

Any views on dealing with type 1 in children (under 10’s)
as there are so many factors to consider at every meal/BG test time/snack time
such as current reading , time to next insulin dose , GI of meal (will it be eaten),prior activity levels , expected activity level , BG trends in last few days etc etc
Is it possible (even on MDI) to get BG into the 7’s or does that meaning running to tight and causing damage due to hypo’s ?

Can you over analyze and end up just going round in circles , is it best just to treat each day as a fresh start and just try and react to that days issues.

I am starting to get a constant headache as everytime we make one change to try and correct an issue it seems to cause another

thanks
Matt
 
Do the best you can.

Children are so unpredictable, in their eating, growing, running, lazing, that personally, i think tight control all the time is a futile exercise.
One day they're ful of energy, running around all day, the next, they do nothing and aren't hungry, day after very hungry eat you out of house and home and then just a few more biscuits.

What insulin reigime is your child on? There are different benefits and fallbacks to each, and they all bring their own issues.
Generally, i'd advise you to look at things over a week / few days. If something has been consistently high / low for a few days at a time, then it's probably something that needs to be changed.
Micro-managing diabetes for children does more harm than good, i.e monitoring absolutely everything they eat, never sweets, never chips, tests every hour etc.

If your child was recently diagnose they're stil most probably in the 'honeymoon' period. This means their pancreas is sporadically producing insulin. This really knocks 'tight' control out of the window, as there's no way to know when and how much the pancreas will produce.

Do the best you can, while still letting your child enjoy themselves. It's a very hard line, and it is hard on the family.

Good luck :)
 
Hi, I agree - just do the best you can. Two of my kids are diabetic. My daughter 7 and my son 5. My daughter is far easier to control, far more predictable and rarely has a low or high reading. My son on the other hand is far harder to control and varies all the time. We do exactly the same with both of them, but it seems that one child is easier to control than the other. For example my sons ratios change at each meal times, yet my daughters seem to stay more constant. My son also seems to need more levemir at night, yet during the day the levemir seems to make him need snacks in between meals. He is still only on 3 units given at 7pm so we can't really split such a small amount.

I can totally understand your concerns and frustations. As a parent of a diabetic child, your life revolves around their diabetes, measuring all their food, keeping food diaries and the constant blood checks. You hope by doing this that you can achieve good readings, but this is often not the case since it is not an exact science. What works one day doesn't necessarily work the next. You can only do your best and try and get the best control you can. I read someone that even the best controlled diabetics still get around 20% of their readings out of the desired range.

Give yourself a pat on the back - you are doing all that you can. Leggott
 
I think your subject says it all. I find diabetes to be a fairly relentless occupation. I aim to do as many normal things as possible so have learnt to be a bit of a fortune teller for when Khaleb may go high or low. In the first year Khaleb's blood sugars frequently bounced from "HI" to 4mmol but being 8 months old didn't help. In the last year Khaleb has had very steady blood sugars (when well) and his latest hba1c was 6.9 (can I gloat a little). I can't say how I got to this point except to say lots of trial and error and listening to what worked for other people. The only food off the menu is banana as it will always send him into the 20's. I find getting good night control the biggest battle and have forgone many nights of sleep. Keeping meal times quite rigid as well as long acting injection times helps a lot. If Khaleb was a bit high I'd prefer to pick a lower carb snack/meal than give a correction dose. It is easy to fall into the trap of correcting, going low, bouncing back up and having to do lots of extra finger pricks. He still gets a couple of figures most weeks just under 4mmol and some high or low numbers just can't be explained and it's best just to move on.

I try to just look at the big picture. Erradicate low's first and then work on areas that are a bit high.

It gets a bit easier but kids are just so different to adults.
 
From what I have read and heard I think managing good levels in children is very tricky. As you say there are so many factors. If Jess gets excited about something that they're doing at school that day it can affect her BG levels. Colds can affect readings too as does exercise. Each child is different and what works for some might not work for your child.

Right now we are experiencing the best control we have had since Jess got diagnosed 4 years ago. I read a very good book that explained type 1 well to me and in a way that I could understand well, this armed me with the knowledge I needed. I also have 4 years of experience now knowing how exercise, sickness, emotions and certain foods affect her readings.

We switched onto a basal (Levemir)/bolus (Novorapid) regime which seems to be working very well. And the other thing we try to do is keep a good routine week in and week out. This keeps emotions and exercise on a fairly predictable level.

I've noted down how different foods affect her BG levels, so for example if we're having pasta for the evening meal I know that her levels will fall initially but then climb through the night. On these nights I'll give a little more Levemir at bedtime and cut back on the Novorapid a little. Or, pasta is a good meal to have on the evenings that we've had swimming lessons. The effect of exercise that afternoon lowers Jess' blood sugars through the night. If she eats pasta the two effects counteract each other. If she has a very low carb evening meal then I know to cut back on the bedtime Levemir and I won't give her a very low carb meal on an evening after swimming. Not unless I want to be getting up a couple of times through the night to feed her a biscuit.

This sort of knowledge you can only learn from experience and by writing things down so that you can look back and start seeing patterns. I found keeping a detailed record of food, insulin, readings, exercise etc gave me some data that I could analyse and start seeing patterns from.

Don't allow it to get you down if you get readings that are not what you wanted. Just try to learn from that experience and move forward with the knowledge. We still sometimes get a reading that makes no sense at all, not everything can be explained it seems.


Jen...congrats on that Hba1c for Kaleb, that's very good! :)
 
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