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Just wanted to say hi

D

darceeday

Member
Messages
20
Type of diabetes
Parent
Treatment type
Insulin
Hi,
It has only taken me 9 years to join!!
I have a 14 year old daughter who was dignosed when she was 5, I have used the site over the years for information just never got round to joining, but since I now have not had a full nights sleep for 6 months because of her having unexplained night time hpos, 1 week in icu after being found in a coma on a school trip (low bs) and unhelpful medical staff I have found myself here looking for help as I have no answers as to why it is happening and no amount of adjusting insulin is helping.

Thanks for reading DD
 
Welcome,

I am actually new here myself, although been on other forums for years.

Has there even been mention of an insulin pump for your daughter. She is getting older but even still the diabetes can be very unpredictable as a teenager.

How involved is she with her diabetes management....?
 
Brian_H said:
HI, I'm new here as well.

What sort of insulin is she on ?
How often does she test her BG ?
Click to expand...
Hi she is on nova rapid and was on levimer up until Thursday of last week, when they changed her to lantus and dropped her units, but on sat morning I was still up and I did her bloods at 2.30am and they were 17 somthing made me stay up, I redid her bloods at 3.10am and she was 1.9 !!!!
most night I will do her bloods every 1 1/2 - 2 hours. her bloods during the day are good and she takes her last injections at 18.00 they have added an extra snack in at 10.30 which could explain the high but they cant explain the drop they are happening every couple of nights.
She has even got me to start doing her injections again to prove that she is not taking too much insulin (which I new she would not do)
 
Hi. Brian_h has asked some relevant questions. Also is your daughter normal or overweight? It sounds like quite a problem but with a bit more info we may have some suggestions
 
novorapidboi26 said:
Welcome,

I am actually new here myself, although been on other forums for years.

Has there even been mention of an insulin pump for your daughter. She is getting older but even still the diabetes can be very unpredictable as a teenager.

How involved is she with her diabetes management....?
Click to expand...
Until the coma she did all her diabetic managment, and was doing a great job, but this has knocked her for six. they have talked about the pump but they keep putting it back, they said Dec then Jan and now March so in the mean time they have changed her insulin. I have 1 doc saying they think there might be a problem with her insulin absorption that it is storing up and they releasing it all at the one time, and I have another consultant saying that this could not happen. S o I dont know what to do.
 
Daibell said:
Hi. Brian_h has asked some relevant questions. Also is your daughter normal or overweight? It sounds like quite a problem but with a bit more info we may have some suggestions
Click to expand...
she is well within range for age hight and weight
 
Brian_H said:
When you say "last injections at 18:00",, do you mean Novorapid and Lantus both at that time ?

How much Lantus (and what time if different from 18:00) ?

How much Novorapid in total in a tyical day ?
Click to expand...
She takes both at the same time as she is about to eat, she takes 2 units of Nova Rapid for every 10g of carbs so about 10 units of Nova rapid and 10 units of lantus so it wouldnt matter if she mixed them up as a one off. She is ruffly taking between 40-50 units of nova rapid a day and 10 units of lantus.
 
Brian_H said:
Yes 10 units of Lantus is not a lot, but having said that, I weigh 80 kg with a BMI of 22, and I only take 8 units. at about 9pm.

It could be the Lantus, I don't believe that these basal insulins are suited to some people (myself included). They give a constant absorption over uo to 24 hours (in the case of Lantus, 24 hours allegedly), but the body's resistance to insulin varies all the time, and it's at its lowest resistance in the early hours of the morning. If one takes a dose of Lantus to be working at its most efficient in the daytime, then I have found using my own Dexcom CGM in the past, that one goes hypo at night. Thus, in my case, my dose of Lantus is so that I don't go hypo in the night, but it's not enough in the daytime, so I "bolus up" with Novorapid. Two doses of Levermir are not so good either, because they last for up to 18 hours, meaning that you get overlaps with Levermir. I have tried going for several days without any basal insulin, just using Novorapid, and the results were not much different to a very low dose of Lantus. Another option that I haven't tried, is to use Lantus, with a bit of Levermir taken at 8am at the latest. That way the Lantus lasts 24 hours, with Levermir for daytime, exoiring by nightfall.

A pump overcomes all these issues.

Just one other question, how much Novorapid at 18:00, and at what ratio to the carbs ?
Click to expand...
she is normaly 2 units for 10g and she normally eats 50g of carbs, they have moved her lantus& levimer injection times around and have tried splitting them to try and solve the problem. I Should have said when she ended up in the coma she did not need insulin for 36 hours! but because she moved hospitals nobody did an insulin or C-pap test until just after they had restarted her on insulin!! I know her teacher supervised her injections the night before and she kept her insulin overnight. which is also the case at home because we have young children so my daughter locks it in a kitchen cupboard at 18.00 so little hands cant get it.
I belive her problem is with the basal insulin as she was very well controlled until they put her on this plan, I am hoping that If and when they put her on the pump this will solve the overnight hypos.
 
I'm sure the doctors will have checked this one but just in case they haven't.
Does she have any lumps or dents from repeated injections? These can be the cause of varied absorption.
http://www.diabetes.co.uk/conditions/lipohypertrophy.html
Getting background insulin right is really important as Brian says.
Unfortunately adolescence brings into play all sorts of hormones which aren't necessary stable from day to day.
 
Brian_H said:
I did an edit which crossed with your reply.

One thing about Novorapid, is that for some people, the ratio of insulin to carbs is not constant during the day. It could be that you need to reduce the amount of Novorapid at 18:00. Novorapid can last for up to 6 hours, and it can give a little "kick" at the end. If her stomach absorption is fast, then the Novorapid might be giving a kick 6 or more hours later.

You could also try reducing the Lantus, but this will mean BG is then higher in the daytime, maybe add 1 extra unit of Novorapid to some of the bolus injections, but it has to be done carefully with frequent BG checks between meals. You may even find that you don't need to add any extra Novorapid, because if it is the Lantus causing the problem, then reducing the Lantus stops the night time hypos, which reduces the requirement for insulin in the datime (night time hypos cause decreased insulin efficiency in the daytime).

IMO it could be one or the other, or both. A pump solves this issue, maybe at night time with an empty stomach, she requires no insulin at all.


NB: stomach emptying varies from person to person, and even day to day for one person.
BUT generally, young people have much faster stomach emptying than older people. In younger people, 6 hours is the accepted time for the stomach to empty.

So in the early hours, with an empty stomach and reduced inulin resistance, hypos are common.
Click to expand...
 
Thanks Brian you are thinking along the same lines as I have been , so its nice to know I am not mad, but when you feel like you are banging your head off a brick wall when you ask questions or suggest reasons to the doc's, you start to question yourself and every move you make. I changed her nova rapid carb ratio last night to 1 1/2 to 10g and she ran most of the night at 10 until this morning when she went up to 13 but by the time she got herself down the stairs before her injections and breakfast she was at 8.5. So much better than the night before.
 
phoenix said:
I'm sure the doctors will have checked this one but just in case they haven't.
Does she have any lumps or dents from repeated injections? These can be the cause of varied absorption.
http://www.diabetes.co.uk/conditions/lipohypertrophy.html
Getting background insulin right is really important as Brian says.
Unfortunately adolescence brings into play all sorts of hormones which aren't necessary stable from day to day.
Click to expand...
Hi, it's the first thing they checked but she is very good at moving her sites around. Trust me perfect she is not, but she has choosen to rebel in other ways rather than muck about with her diabetes so she she has a good look at her site a couple of times a week. think it might be more a teenage vain thing but hay ho what ever works. being a teenage diabetic is horrible thay have so much to deal with constent hormone changes.
 
Last edited by a moderator:
darceeday said:
10 units at 18.00 so not that much
Click to expand...

I don't know if you were told this but generally you need a lot less insulin when you change from levemir to lantus, I swapped from lantus to levemir a few years ago and was told I'd need around a third more, as it happens they were quite right and I ended injecting more than the third and still couldn't get good control with levemir.

I would try cutting back on her lantus dose by 2 units and see how she gets on with that, you can always up the dose by 1 unit if her bg goes the other way,

You should ask if you can change hospital diabetes clinics if her current team are unhelpful, failing that ring Diabetes UK up and ask them for some advice.

Good luck!
 
Daibell said:
Hi. Sadly I can't help much with what is a very complex problem but I note that the NovoRapid ratio is very high. Typically it would be around 1 unit/10 gm.
Click to expand...
Hi thanks for your reply, she was on 1 unit for 10g until around October of last year when all this started to fall into a regular pattern, it was the hospital that put her on the 2 units for 10 when they started playing about with her levimer. she checks ratio every 3 days so somtimes she is back at 1 unit for every 10 and somtimes she is 2 but so far she has not needed more than 2.
 
noblehead said:
I don't know if you were told this but generally you need a lot less insulin when you change from levemir to lantus, I swapped from lantus to levemir a few years ago and was told I'd need around a third more, as it happens they were quite right and I ended injecting more than the third and still couldn't get good control with levemir.

I would try cutting back on her lantus dose by 2 units and see how she gets on with that, you can always up the dose by 1 unit if her bg goes the other way,

You should ask if you can change hospital diabetes clinics if her current team are unhelpful, failing that ring Diabetes UK up and ask them for some advice.

Good luck!
Click to expand...
t
 
They did thanks and they have cut her back since moving her onto the lantus was going to drop her down a bit last night, but her temp shot up nose and eyes started running and she is now fully loaded with a full on cold so I am not going to do anything at the moment with her.
 
I know I do thanks, but my after her ending up in a coma both of us have had our Confidence knocked.You begin to question everything. I also heve that guilt feeling as I wasnt there because she was on a school trip the thing is I almost went to get her the night before cause I had this feeling. I was thinking about getting her a CGM as I think this might get her Confidence back up as it would allow her to know what is going on with her body and for her to work out a her own plan with some help of what she needs to do and give her, her control back..
 
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