Help with changing doses please

I think the low readings from today are from the day before when she did the football all morning and then she did swimming this day. I was suggested once to add up all Khaleb's long acting insulin and on days he does extra exercise to reduce the long acting insulin by 10%. This has been fantastic for Khaleb. This way you are not spending a day treating hypos or lowering the insulin a day too late and then having high readings the next day. This has been my experience with Levemir anyway as it really does take a few days to settle whenever you change the dose. You'd have to experiment a bit with this but I've really found it fantastic. Sometimes if you don't know that it is going to be a big exercise day you might be a bit behind but having the Levemir split still makes it heaps easier. I've used this method when we've been away on camp diabetes and also going to theme parks as these have been the biggest causes of lows in Khaleb that have been troublesome. Your other choice would be to alter your carb ratios slightly with exercise on the day and the day after. Hope this helps

Can i ask what you try to correct back to? I usually only try to correct back to 7-10mmol. The only times I might overdose Khaleb a little is if we are going to Maccas for morning tea and his morning NR can take some of the carbs that is over his usually morning tea allowance. This requires a little bit of timing on my part but I avoid big spikes and Khaleb gets a moment of doing something that everyone else is doing (minus the pancake syrup).

Three cheers for finding some good control. The blip in the evening isn't something to worry about but I would have been inclined to correct it so the higher level didn't remain for many hours. Again, for Khaleb I would have only corrected back to 10mmol so that he'd still last the night. Having the 8.30pm and 10.30pm checks going up would really make me correct but if there was a fair drop in those two I might be a bit more cautious. Just thoughts...

Yeah, when we eat out it is a bit of guess work. Any dessert would be really hard to calculate as the sugar content is going to vary heaps. I do count nearly any veg that isn't green. Corn is something that can be noticeable in Khaleb.

The nights that your daughter drops from a very high figure to a much lower figure can sometimes be the bodies own mechanism of flushing out the excess glucose so if you corrected a little bit you avoid that function and get a more predictable drop overnight.

Even though our kids have lost insulin production all the othe aspects of the bodies blood sugar control are usually still intact. I think there are some people that also have an auto-immune attack on their alpha cells in the pancreas and those produce the hormone used to lift blood glucose. This is my interpretation of how someone gets brittle diabetes.

http://www.youtube.com/watch?v=BDATgiMwRNA

Have you watched the Type 1 Mum song yet?

Totally agree that changes in Levemir show up days after. You really see why they tell you to only make small changes every few days. I also find it a pain that fixing the Levemir then means changing ratios to carbs. Because Khaleb is little I don't have a lot of leeway to alter NR as it will make him hypo acting to quickly. We all walk a tight rope every day trying to keep the balance.

Poor Khaleb had his blood test on Monday. I hate having 3 people holding him down while he screams. He has to get his thyroid levels checked every 3 months and they do his hba1c at the same time. I get the results on Tuesday. He either goes high or has a hypo after this test. Yesterday morning it was an odd hypo (3.1) at 10am.

I think you should be very happy with what you are doing. There is nothing out of whack with that lot of readings. You would get a good average and a1c with those levels. If you need to put the levemir up only do it by 1 unit or half a unit and wait a week before making more changes. If you know she's going to do heaps of exercise try taking off the 10% Levemir for that day and then put it back up. You are now only making small corrections and not having hypos makes life a lot more liveable. I don't know too many (actually any) kids on MDI that can stick completely to that 4-8mmol all day other than you fluke it occassionally. Pat yourself on the back!

Oh well, we all have days like that. Khaleb popped a 20mmol late this afternoon even though he was 7.7 at 2.30pm and only had a small afternoon tea. He's got a bit of the runs also which is very rare for him. I'm hoping it is only a minor tummy bug and doesn't turn into anything horrid overnight. I'm tired and got a bit of a cold so the last thing I need is a night without any sleep. His bsl is back to 8mmol now and he seems happy enough so I'm keeping my fingers crossed it was just a glitch. He had a weird 'out of the blue' hypo a couple of days ago and that is sometimes an indicator he is about to come down with some illness.

Do you have some idea what caused the higher levels?

I had a friend, and her 2 sons, over this evening for dinner. Her 3 year old has diabetes and on a pump and I'm learning the ropes so I can babysit for her on the odd occassion. I carb counted his meal, did the bolus and he had really good levels - almost exactly the same before and after. His mum gets terrible levels but doesn't carb count very well. I've treated one of his hypos before also and his mum was surprised how quickly his level came up. Apparantly she and daycare spend half to an hour to raise his level above 4. I was quite impressed with the pump and if it wasn't for Khaleb having Down's I'd be jumping to get one. If you know someone with one you and your daughter should take a look. They can be hard work - so I'm told - but from my little experience they have some distinct advantages.

Even without pump funding if we take out Private Health Insurance we would be given a loan pump for the 12 month waiting period and then be able to purchase a pump and just pay the gap fee. Khaleb still wouldn't qualify but after having a play and being a good carb counter I think I would settle in with one in no time. You can always contact Roche or Medisense yourself and see what they can offer. There are some disadvantages to the pump that you'd need to discuss. I had a look at a quick set insertion kit and I personally think I'd rather push the cannula in myself than have the big click and bang effect. Anyway, totally off topic.

Khaleb had an excellent night and woke with bsl 7 this AM. I think he must have just had a 12 hour bug. He had a whinge at daycare yesterday which is unlike him and also had a sleep. At least it hasn't turned into something else. I still checked him at 1.30am but he stayed in single figures all night.

Hope you didn't have another bad night. If Khaleb had a really high carb meal, especially pizza or some other take away, I'd be giving him 2 injections also. Giving one big bolus just sends him hypo and after treating that he then goes high hours later. Sometimes I still end up with the same problem if the injections are too close together and I get the stacking effect. The joys of diabetes, hey!

I've had some not so great nights also. Khaleb has been high some nights at 10pm and needing a correction and then last night he was 2.8 at 10pm. I rechecked him a bit later and he was 7.0 so I went to bed and checked him again at 2.30am and he was 2.6. He then woke up this morning at 12.5 grrr. We go to clinic shortly so I will find out if these problems are due to his thyroid condition or just diabetes being a pain. Will get back later.