Insulin doses for T1 13 yo

[SarahCarrick]

Hi there... My son was diagnosed at start of March. He is taking tiny amounts of insulin... 5 of long acting and 0.5-1.5 of short acting depending on what he is eating. At times he is not taking any insulin if he's doing PE/sport. He is finding that he is struggling to keep his blood levels up at times. I know he is in the honeymoon period and this can last for some time.... Are such small amounts that unusual? Even with half a unit at breakfast he's finding he is eating in lessons to avoid hypo. He's getting increasingly frustrated and trying to convince himself that the Drs have made a mistake and he's not got diabetes after all...obviously not the case but wishful thinking! Could anyone offer any advice?

 

[noblehead]

Have a word with his DSN as it may be the case that he needs to reduce his basal insulin to reduce the hypo episodes, but yes it is quite normal to be on small doses when in the Honeymoon Period.

 

[azure]

@SarahCarrick Does your son count carbs? If not, that might help as he/you could ensure he has an appropriate amount of carbs each meal to try to avoid going low.

 

[himtoo]

definitely have a word with the DSN - and I agree that low or possibly no dose may be required at a given meal especially if physical activity is involved.

 

[SarahCarrick]

Thanks for your replies... Yes we are carb counting. The ratio we were given is currently 1:55 but that def needs tweaking. We are just concerned that the doses seem so exceptionally low! I know it's very individual and this is unlikely to last.

 

[Ellie's mum]

Hi

My daughter was diagnosed T1 in February, she is struggling with her levels in a morning. She only has 0.5 units with her breakfast regardless of what she eats, her bloods can be in the 11s 2 hours later but then can be in hypo levels an hour after that! Although once we get past lunch the rest of the day is pretty much hypo free with different carb ratios at every meal.
Her school have been fab at dealing with the mornings and so has her DN who we speak to nearly everyday!

 

[azure]

Thanks for your replies... Yes we are carb counting. The ratio we were given is currently 1:55 but that def needs tweaking. We are just concerned that the doses seem so exceptionally low! I know it's very individual and this is unlikely to last.

When I was first diagnosed, my basal was 2 units a day, if that makes you feel any better. People's insulin needs can vary enormously. I understand why your son hopes he doesn't really have diabetes. I used to hope that too. I thought maybe it was a temporary blip or something.

Speak to your DSN about changing the ratio if you feel it's not working for your son. If he's consistently going low after, say, his normal breakfast, you could always add a few extra carbs and see what result that has. You may then find a good dose for that meal. That's what I did before I knew my ratios - eat the same thing and test two hours after to see what insulin amount worked.

For sport, does he have glucose or similar beforehand? Again, hopefully you'll find an amount that works, and he'll then be able to have that routinely before his exercise.

If he continues to have small doses, you may want to look at the idea of a pump. Pumps can do tiny doses and can also make adjustments for exercise.

It sounds like you've made a great start though! Never underestimate how hard Type 1 can be, especially in the early days.

 

[TorqPenderloin]

Thanks for your replies... Yes we are carb counting. The ratio we were given is currently 1:55 but that def needs tweaking. We are just concerned that the doses seem so exceptionally low! I know it's very individual and this is unlikely to last.

I'm 210 pounds and diagnosed 8 months ago. This week, my basal got as low as 6 units/day and my bolus can be as low as two .5 unit injections in a given day. HOWEVER, when I don't exercise and when I'm on a high carb (300g+) meal plan my basal can be as high as 20-25 units a day and my bolus needs can be in the 10-15 units/day range.

Exercise has a PROFOUND effect on my insulin needs. I can burn as many as 1000-1500 calories/day just through the exercise I do. That also cuts my insulin needs down by roughly 1/3rd of what I'd otherwise need.

Point being, your son is probably much smaller than I am, but our insulin: carb ratios aren't terribly far off. The honeymoon period really does complicate things and I've found that my ratios are by no means set. In a single week, there could be a day where I need less than 10units/day compared to another day where I need more than 30 units.

 

[himtoo]

Hi @SarahCarrick
with a diagnosis only 2 months ago there is so much to take on board and all the advice can become a bit of a blur.

try and slow things down , take things 1 day at a time , celebrate the things that go right , and try not to worry about the things that don't.
Diabetes lasts for a long time - i've been doing it for 43 years and not every day goes to plan for me -- point being that all of us are just doing our best , it is all you can do with your son, hopefully he is starting to get a handle on things.
[hugs]

 

[SarahCarrick]

After discussion with PDSN we are cutting out tresiba completely and just using novorapid to see how he goes for a bit. Thanks for all your reassurances! Hopefully this will give him some relief from the endless hypos!
Thanks again
Sarah x