I don't quite know what to try next! 12 year old son's (diagnosed 2.5 years ago) hba1cs have not been so good - 7.4, 7.7, 8.4, 8.1. So we have swapped from Lantus once a day to Levemir twice a day as his basal (with Novorapid as his bolus). This was to solve 3 problem areas
1) we were having to give him BIG bedtime snacks to prevent night/morning hypos, especially after sport, which is almost every day, but that meant his bgl would have to rise up into the teens mmols+
2) he was often high all morning - often his 10.30 morning breaktime bgl was well into the teen numbers again but fell to the normal range by lunch at 12.15.
3) his bgl was often high before tea at 6 p.m. even if it was 'normal' after school and he had not snacked after school - thought to be due to liver glucose
So we've swapped to Levemir, split the dose evening and morning and tinkered around with the doses more than once. Instead of 5 Lantus at night, he started on 5+1 Levemir but we have settled on 3.5 Levemir at night + 2 Levemir in the morning.
Problems 1 and 2 have been sorted more or less but 3)late afternoon high bgls still occur almost every day.
The obvious solution is to increase the morning Levemir again but with each increase in basal we are having to decrease the lunchtime bolus too (from 3.5 units to 2.5 units to cover 70-75 carbs)
to prevent hypos at the end of school!
Wise people...
How little bolus can he survive on? Do I just keep increasing his lunch carbs/decreasing the Novorapid. He seems to take much less insulin than other kids anyway.
Can we split the Levemir 50/50? or even have a bigger dose in the morning than in the evening? I keep reading how smaller doses of Levemir last less time and then about adults injecting 30+ units of it - so how can son's 5.5 units possibly last all day? I don't get that.
I read on here about basal testing? What's that? Will it help me work out if his basal is right?
Anyone any ideas what we should try next to prevent the late afternoon rise in bgl? What's worked for you?
1) we were having to give him BIG bedtime snacks to prevent night/morning hypos, especially after sport, which is almost every day, but that meant his bgl would have to rise up into the teens mmols+
2) he was often high all morning - often his 10.30 morning breaktime bgl was well into the teen numbers again but fell to the normal range by lunch at 12.15.
3) his bgl was often high before tea at 6 p.m. even if it was 'normal' after school and he had not snacked after school - thought to be due to liver glucose
So we've swapped to Levemir, split the dose evening and morning and tinkered around with the doses more than once. Instead of 5 Lantus at night, he started on 5+1 Levemir but we have settled on 3.5 Levemir at night + 2 Levemir in the morning.
Problems 1 and 2 have been sorted more or less but 3)late afternoon high bgls still occur almost every day.
The obvious solution is to increase the morning Levemir again but with each increase in basal we are having to decrease the lunchtime bolus too (from 3.5 units to 2.5 units to cover 70-75 carbs)
to prevent hypos at the end of school!
Wise people...
How little bolus can he survive on? Do I just keep increasing his lunch carbs/decreasing the Novorapid. He seems to take much less insulin than other kids anyway.
Can we split the Levemir 50/50? or even have a bigger dose in the morning than in the evening? I keep reading how smaller doses of Levemir last less time and then about adults injecting 30+ units of it - so how can son's 5.5 units possibly last all day? I don't get that.
I read on here about basal testing? What's that? Will it help me work out if his basal is right?
Anyone any ideas what we should try next to prevent the late afternoon rise in bgl? What's worked for you?