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Type 1 Hypos after each meal

Rocky Racoon

Rocky Racoon

Member
Messages
11
Type of diabetes
Parent
Treatment type
Insulin
Hello,

Just a quick question, I seemed to have lost control of my son's ratios and am struggling in what to tweak in the way of bolus or basal.

He is high at night so we have increased his basal from 5.5 to 7. He has it once at night and since we have increased it his levels have dropped from 16's - 20's to 8's - 12's during the night.

But he has hypos pretty much after each meal (2-3 hrs after) and so we have decreased his meal time ratios. But it's getting a little silly, his breakfast ratio was 1:10 but now 1:20, other ratios similar in their changes. And he's still having hypos every time he eats!!!

It's bizarre, it's almost like he's running on basal alone. The logical thing with all the hypos would seem to decrease the basal, but when we do that he then spends all night high.

Am I missing something obvious?
Thanks.
 
How old is your son?

Which insulins does he take at the minute?
 
Take less mealtime insulin. If he can eat a meal without needing any insulin that's great. Just make sure to keep checking his blood sugar after - his insulin needs will certainly change over time and you will have to adjust his doses to account for it.
 
Just a thought, but have you thought about the Freestyle Libre? I know its a little expensive, but you don't need to use it all of the time, your diabetes nurse/consultant may even give you a free sample. But they are great for plotting the timeline graph of how your sugars respond to food and insulin and the adjustments you can make.
 
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another thought .......... how long is he diagnosed. ?
if it is his first year to 18 months he could be in his "honeymoon" period.
this is when the body is still producing some insulin and amounts of insulin needing to be injected can be reduced.

are you speaking with your son's Diabetic Nurse for advice ?
 
Rocky Racoon said:
Am I missing something obvious?
Click to expand...

Maybe split-dosing his levemir (or changing to an alternative) would give a better 24 hour coverage then you could look at his insulin-to-carb ratios @Rocky Racoon

But either way I'd discuss things with his DSN asap as going hypo after every meal must be draining for the boy,also ask if he could change to a insulin pump as this gives you so much more flexibility when adjusting basal & bolus doses. Hope you get things sorted soon.
 
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What time do you do the Levemir each day - I was running high at night with it when I was taking it first thing in the morning each day. I switched it to lunchtime, and then to mid-afternoon, and the background control seems much better. I would try that and see if over a few days/weeks you can reduce the dose slightly and this might help with the hypos.

As others have said, if he can manage meals with this alone then great, but my nurse taught me to work out my insulin very carefully dependent on what I was eating (speak to your Clinic Nurse) and I no longer seem to have the problem of running low except when I miscalculate
 
Wow lots of replies - thank you very much to all of you.

He's been diagnosed 22 months now and is currently trailing the Libre. I haven't seen a timeline graph from this yet, I will get onto that.

He doesn't split the Levemir , he has it about 8pm. Splitting it does seem like a possibility because about 4pm (when it runs out) his levels can shoot up into the late teens/twenties.

He does run around a bit, but not always, I don't think it's an exercise thing. And he definitely needs insulin with his meals.

I just can't figure out how to keep him low during the night without these hypos after meals. Maybe I do need to decrease the bolus by a lot, it just seems like a huge shift in ratios, and we are always tweaking them here and there, but this seems like all ratios changing at the same time - and changing a lot.
 
@Rocky Racoon Did the after meal hypos start after you upped his basal? If so, maybe he needs less basal during the day than at night. A Levemir split gives you more flexibility and, with his DSN's help, you could try that.
 
azure said:
@Rocky Racoon Did the after meal hypos start after you upped his basal? If so, maybe he needs less basal during the day than at night. A Levemir split gives you more flexibility and, with his DSN's help, you could try that.
Click to expand...

I agree with this as I split my levimir 10 units am and 16 units pm.
I know I'm not a kid anymore LOL but the analogy still stands.

Regards
Tony
 
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