fasting test

[Matt1212]

Hello Everyone,

Anyone had any success with a fasting test to confirm basal is correct ?
Have tried on a few occasions with my daughter and she has gone low each time.
I assume this would indicate that her levermir dose is to high.
However does it make sense to have a slightly higher dose to cover snacks between meals not treated with novarapid.

thnaks
Matt

 

[leggott]

Hi, That's a really good question and one we've asked ourselves about our kids (2 of which have type 1). We've never made them fast but since they are still in the honeymoon period they subsquently only need very small doses of levemir (my son 2 and a half units at night). They then go to bed with a very small snack may be between 5 - 10gram of carb (depending what their BG is before bed). Strictly speaking the levemir should only be used as a background insulin since it is slow burning. The novo rapid should be used at mealtimes and snack times as it acts far more quickly - mimicking the pancreas. The other problem with using levemir to cover snacks is that if a snack is missed, this could result in a hypo. It also means that they will need to have a larger snack before going to bed in order to cover the extra insluin, resulting in elevated bg levels when they go to bed. You don't say how old your daughter is, but I know in my area there are a number of younger kids who take mixed insulin in the morning which covers their breakfast, mid morning snack and lunch, they then have novorpaid at tea and levemir before bed. Again this regime is not exactly mimicking the pancreas, but it is perhaps easier for smaller children who like a morning snack or when it is difficult to adminster injections at school/nursery. Leggott.

 

[Matt1212]

Aislinn is 5 years old , she has 5 units of levermir at 6pm (only been on MDI for 1 month , before that 11 months on the mixed insulin twice a day)
What you say makes sense and we have had a few hypo's recently so I think reducing the levemir to 4.5 makes sense.

Aislinn is used to 30g carb at evening snack and it is hard to change.
Can I ask what you do if your kids want more than 5-10g carb at bed , it is hard making a child go hungry (and only so much cheese/frankfurters/ice pops can be eaten without complaint...)

 

[leggott]

Hi, My son is also 5 and he was also on mixed insulin until July this year. My daughter is nearly 7 and she is still on the mixed insulin but we are changing this in the Xmas holidays. It is difficult where snacks are concerned. My particular problem is when one can have a snack and the other one can't - as this can cause lots of upset! I tend to feed my kids at 5pm and try and give them a big tea to really fill them up, I normally only give them a pudding or a treat with their tea so they don't expect one at bedtime. They go up at 8pm and we do a blood test to determine if they need a carb snack before bed and as I said before this tends to be only something very small. Sometimes we do give them a bigger snack and inject novorapid but I don't really like doing this as they are going to bed and there is the worry of a hypo. Small kids tend to be grazers and like to eat little and often but unfortunately this way of eating when diabetic is not ideal as it makes controlling bg much harder. We try and give them fruit like melon and berries or a squeezy yogurt at bedtime since these are fairly low in carb or i make hot chocolate with cocoa and milk. Popcorn is another good snack as a small kids bowl is probably only 10g carb. You could also try rice cakes or a small bag of kids crisps like (Pom Bears) as they are only 10g. I hope these ideas help. Leggott.