drastic reduction in doses

[loopyloo]

Hi,

Just a thought as I don't think anyone has mentioned it yet.........it sounds like she could be going through a honeymoon period. I thoroughly enjoyed a period of about 6months where I stopped using insulin altogether about a year after starting, unfortunately as often happens, a virus brought an abrupt end to this and I went staight back to basal bolus.

I queried all the hypos I was getting even though I kept reducing my doses, the dsn didn't have any idea what could be causing it, luckily the consultant i had at the time was fantastic and explained that a 'honeymoon period' can occur after starting insulin as ( I may not explain this very well) because your body has had chance to recover slightly from the strain of high glucose levels your pancreas has a last ditch attempt to work properly, as I mentioned this usually ends if you catch a virus or suffer from a stressful event, honeymoons can last for weeks or months.

Regards x

 

[Snodger]

The merits of MDI/pump is that now she's almost a teenager (boy does time go fast) so not only if she hasn't already started pubety she will do, and the 'non existant' social life of a teenager these two methods will help her to have more flexibity, the pump the most has not only will can you react to raging teenage hormones a lot more easier, you don't have to go home because you haven't got your insulin to stay :roll:

I also wonder if actually her hormones are already kicking in, and that is why she's started to experience some more difficulties. I know 11 sounds young for that, but certainly by the time I was her age I was beginning to get hormone-tastic. Her body may be starting to gear up for menstruation etc. Many of us have very fluctuating insulin sensitivities around menstruation - worth bearing in mind, even if she hasn't formally started yet, that her body may still be experiencing some of the changes around it.

 

[Spearmint]

Hi,

Just a thought as I don't think anyone has mentioned it yet.........it sounds like she could be going through a honeymoon period. I thoroughly enjoyed a period of about 6months where I stopped using insulin altogether about a year after starting, unfortunately as often happens, a virus brought an abrupt end to this and I went staight back to basal bolus.

Regards x

Apparantly she had that 3mths after diagnosis for 2mths, unless it is possible to have another one???

 

[Spearmint]

I also wonder if actually her hormones are already kicking in, and that is why she's started to experience some more difficulties. I know 11 sounds young for that, but certainly by the time I was her age I was beginning to get hormone-tastic. Her body may be starting to gear up for menstruation etc. Many of us have very fluctuating insulin sensitivities around menstruation - worth bearing in mind, even if she hasn't formally started yet, that her body may still be experiencing some of the changes around it.

I wondered that too and asked that at the hospital and was told that if hormones were kicking in we would see highs and bigger doses needed, no idea if that is true or not though!!

Thank you to everyone who replied.
I took the children away for the last 3 days and oh what a nightmare!!!!
I did the same at Easter and all went fairly ok apart from a hypo just before lunch on the first day.
BUT this time she started off the days normal, upped her morning dose to 3 units so she could have a bit bigger lunch but come lunch time her readings were 22 on the first 2 days so gave1.5 units of novorapid and yes you guessed it - 2 hypos before dinnertime!!!!
Going to ring the hospital and try to catch her nurse after clinic to say we will switch to basal/bolus and see if that gives any better stability.

I might be back with a million questions x

 

[Snodger]

I also wonder if actually her hormones are already kicking in, and that is why she's started to experience some more difficulties. I know 11 sounds young for that, but certainly by the time I was her age I was beginning to get hormone-tastic. Her body may be starting to gear up for menstruation etc. Many of us have very fluctuating insulin sensitivities around menstruation - worth bearing in mind, even if she hasn't formally started yet, that her body may still be experiencing some of the changes around it.

I wondered that too and asked that at the hospital and was told that if hormones were kicking in we would see highs and bigger doses needed, no idea if that is true or not though!!

No, not necessarily true at all. A lot of doctors' understanding of diabetes is from textbooks which give guidelines for the general diabetic population, but with diabetes everyone's different. Many people find that they need bigger doses in the run up to a period, and much smaller doses from day 1 of the period. Others find the exact opposite. Some find there's no difference at all, and some may experience fluctuations some months and not others. It's just a case of keeping an eye on it and seeing if there are patterns.

You say she will be starting basal/bolus soon and that may well help a lot; it may feel like harder work at first but it certainly gives you more flexibility and makes it all easier to understand, in my experience/opinion.

the honeymoon thing - I haven't heard of anyone having two 'honeymoons' with diabetes but that doesn't mean it doesn't happen.

 

[LittleSue]

Changing to basal bolus with half-unit pens should help and be more flexible, especially if she is less sensitive to the new insulin, hence in effect the dose adjustments are smaller (hope that makes sense).

I think Snodger's right. I was diagnosed aged 8, but didn't realise the full effect of menstrual hormones on my blood sugar (and how to adjust for them) until I was over 40. It had probably always been a big factor, but things were so haywire it was impossible to tell, until I started the DAFNE (ultra-flexible basal/bolus) regime. Being very sensitive to insulin magnifies the variations. (The joys of being female LOL.) Flexible basal/bolus with half-unit pens helped but I still can't fine tune enough so am waiting for a pump. Modern pumps can adjust the doses by tiny amounts, hour by hour if necessary. It does mean a lot more work, but there are parents on here of children your daughter's age or younger who cope very well with a pump.

Our bodies don't always stick to what the textbooks say, everyone's different. Many times I've experienced something and then been told its "impossible".

Basal/bolus could be a halfway step, to see if you and your daughter can cope with the more frequent testing/injecting, carb counting, adjusting for illness, etc. If you cope well with the practicalities then even if control still isn't good, you'd know whether a pump is a sensible option for your daughter.

She certainly needs to grasp the importance of treating hypos promptly and properly, and teachers need to be aware of the danger of not doing so. As she gets older she'll want to be out and about and independent, and you both need to be confident that she can handle whatever happens when she's away from home. Specialist nurses (DSNs) sometimes visit schools to education staff, to ensure they understand what a type 1 child can/can't do, the importance of treating hypos promptly, etc. In view of the issues you describe perhaps your daughter's DSN could visit your daughter's current school and/or her new school when she starts there?

 

[Spearmint]

Changing to basal bolus with half-unit pens should help and be more flexible, especially if she is less sensitive to the new insulin, hence in effect the dose adjustments are smaller (hope that makes sense).

Basal/bolus could be a halfway step, to see if you and your daughter can cope with the more frequent testing/injecting, carb counting, adjusting for illness, etc. If you cope well with the practicalities then even if control still isn't good, you'd know whether a pump is a sensible option for your daughter.

She certainly needs to grasp the importance of treating hypos promptly and properly, and teachers need to be aware of the danger of not doing so. As she gets older she'll want to be out and about and independent, and you both need to be confident that she can handle whatever happens when she's away from home. Specialist nurses (DSNs) sometimes visit schools to education staff, to ensure they understand what a type 1 child can/can't do, the importance of treating hypos promptly, etc. In view of the issues you describe perhaps your daughter's DSN could visit your daughter's current school and/or her new school when she starts there?

The school have said they don't think it's necessary to have the nurse go in!
Last year i trained 2 teachers in how to treat her but being a Middle school she can not go and find them if she needs help but 1 of those 2 are always on the school trips and have been good with her.

Well, we started with the Levemir and Novorapid yesterday.
I rang her school before she went in to tell the deputy head.
I went in at lunchtime to help with her test and injection and they had appointed 2 TA's to help her at lunchtimes. I am going in for the next 2 weeks until the doses are fine tuned and 1 of them will be there with me to learn from me. The lady i met yesterday was really nice and took a real interest, the other one is on holiday but she used to test her after swimming and work out her snack for her so hopefully it will work out ok at school!!

Unfortunately we've got nowhere with the doses as i forgot to prime the pen with Levemir in yesterday and she got none and then today she has been ill with bad tummy ache and feeling sick.
Her starting doses are 2units Levemir on waking, 0.5units Novorapid for breakast, 1 for lunch and 1 for dinner.
Need to wait for her to get better to see if they are right or not now.

Thanks for your reply