Improvements

[martina]

Hello everyone, I posted a few days ago What I'm I missing, my daughters bgs were always high. Good news is that I have been able to get them down and some or in normal range. I just have a question on whether it's the morning bolus or the basals that I need to take a look at more carefully. Her bgs were on high side so I made a change to her morning bolus and yesterday she woke at 6.0 and at her 10am check she was 6.2 which made me think that the change was correct. However this morning she was 6.3 so would have been getting the same amount of insulin and at the 10am check she was 3.9 which makes me think that perhaps the bolus change was wrong. I know basal check would be good but as she is at school and very active I'm scared that going without food would be a problem. Anyone got any idea's? Thanks for the previous advice I find it very helpful. Martinax

 

[noblehead]

Don't change anything for now, do the bg testing again tomorrow morning and see what results you get and work from there, they say you shouldn't change insulin doses going from one days readings and I do think its good advice.

Maybe try testing her bg at 9.30am tomorrow just in case she is dipping low postprandial.

 

[himtoo]

I would agree with @noblehead -not to make changes on 1 days results.

perhaps a phone call with the DSN with a few days readings -- they are normally very good at spotting trends as that is what they are doing a lot.

 

[martina]

Thanks for advice, She is on half term holidays from today but I will make a note to do that on her first day back. Weekends and holidays or very different to school days and she is on different rates, I have no doubt they will need changing too so I will do
basal testing tomorrow morning. Thanks again

 

[noblehead]

Good luck @martina, himtoo makes a good point that you should run these bg readings past your daughters pump DSN.

 

[martina]

Thanks, I have spoken to nurse who said make changes and ring in couple days if no change. She did agree with what I was doing. Said to get the overnight ones sorted first and go from there.

 

[iHs]

My thoughts on this is that if bg before eating is around 6mmol, then with bolus for food, the bg should be around 8.5mmol 2.5hrs later and not 6mmol. You have to allow for a bolus to safely lower bg to the before meal tsrget within 4-5hrs and not 2hrs even with a pump. It is not an artificial pancreas. If the basals through testing them out were on 6mmol then that should ensure the action from the bolus to lower correctly allowing for the 2mmol rise.

 

[irrationalJohn]

I know basal check would be good but as she is at school and very active I'm scared that going without food would be a problem.

What sort of treatment program is she using?

If your daughter is on a pump then you want to temp basal when active. How much and for how long have to be figured out based on how that individual responds to increased activity.

If she's using a basal insulin, then, yes, I'm not aware of any way to work increased activity in other than by compensating with carbs. But I'm also not sure how the activity profile of the "modern" basal insulins such as Lantus or Levemir might change with exercise.

The one thing I am fairly sure on is that bolusing for and eating a meal prior to exercise can be a ***** to balance out.