Insulin or Excercise?

[eshobabu]

So I have a 6yr old newly diagnosed T1. She is about to enter honeymoon - today she needed 0 humalog and just 1 unit of basal in the morning. What I observed is right after a meal she spikes up into 250-300 range. If she is not active (like in virtual school) it slowly goes down to 120-150 over 3-4 hours. If she is active and running around, it goes down to that within 1 hr of the meal and activity. I have a choice now - do I give her the 0.5 humalog and then deal with the eventual hypo as soon as she starts running around (she is a ball of energy and does not seem to get tired ever) or just let her hover above range for a little bit knowing it will come back down sooner or later depending on what she is doing (jumping on the bed vs watching tv obviously makes the slope down steeper).

Intuition says keep off humalog, let exercise do its magic, but at the same time a bit of humalog boost might help her pancreas honeymoon longer?

I am confused.

 

[eshobabu]

And its 10 pm, she is already heading into hypo territory (90 and falling). Gave her OJ hopefully she will sleep through the night. Tomorrow no basal (endo said reduce basal until she no longer hypos). Just to clarify, the last insulin she had was this morning (14 hours ago) 1 unit basal. She ate about 100 g carbs today plus 15 now from the OJ.

 

[Tophat1900]

We cannot advise on dosage, that's something you'd have to discuss with your doc or DN... if it were me, I wouldn't want to be creating a situation where you know a hypo WILL happen. So, I'd avoid that route. Hypos are serious situations and very unpleasant. A persons body is in crisis mode. It's easier to deal with a higher level I think.

 

[NicoleC1971]

And its 10 pm, she is already heading into hypo territory (90 and falling). Gave her OJ hopefully she will sleep through the night. Tomorrow no basal (endo said reduce basal until she no longer hypos). Just to clarify, the last insulin she had was this morning (14 hours ago) 1 unit basal. She ate about 100 g carbs today plus 15 now from the OJ.

I am afraid that this is the classic difficulty for dosing in type 1s because injected insulin isn't as finely tuned or as reactive to feedback as a properly working pancreas. then you have to account for growth, illness and honeymoons! You presumably want to avoid rollercoasters from low to high as you chase hypos etc.
I am type 1 and if it were my kid I'd probably try and regularise her exercise so that you can fine tune both the timing and amount of the humalog e.g. if she runs around just after the meal you could delay the jab or under dose. It is tricky with a six year old but the more regular her food and exercise habits are the easier this approach is and the less oj and snacks you would need to provide. If her basal dose is correct then you are a huge step forward.
Having a cgm like Dexcom is a game changer too but I know US insurance doesn't always provide this. there are also 'closed loop' systems on the market I think in the US (blood sugar monitor talks to pump and auto corrects it to prevent hypos).
The other thing to consider is diet. TypeOneGrit are a US parent group (of type 1) who follow Dr Richard Bernstein's low carb diet to avoid rollercoasters and to preserve pancreatic beta cell function. they seem to get excellent results however it is something the whole family needs to adopt (also a healthy diet for non diabetics).
Best of luck with your girl .