Newly diagnosed 14 year old

[shellyk]

Hi all, i would really like some advice regarding mu daughter. She diagnosed last week with type 1, And started on an mutiple dose insulin regime. We are now home and begining to come to grips with the news and the regime.

My question is why would her post meal BMs be lower than her pre meal before going up again prior to next meal This is the last 2 Days BM I should mention that this does not happen after breakfast

Pre breakfast 11.3 5 units Nova rapid Pre breakfast 9 6 units nova rapid
Post 16.3 post 16
Pre lunch 19 5 units nova rapid Pre lunch 9.5 6 units nova rapid
post 16.8 post 7.6
pre dinner 18.4 5 units nova rapid pre dinner 14.3 6 units nova rapid
post 13.6 post 8.2
bed 16.5 8 levemir bed 15.1 9 units levemir

I know these levels are still high but as her weight has falling to only 36 KG she was commenced onlose dose which is being increease daily under supervision of opur diabetic nurse. My concern is that if we eventully gets a normal pre meal bm if it drops tham she will be put into a hypo. I don't understand what it happening as i thought blood sugars were suppossed to raise after eating

 

[HLW]

Ask your nurse, they won't mind explaining it all. I assume it's something to do with the levemir not lasting 24hours, but in any case don't worry too much about the figures right now, as long as it is improving that's the main thing. You can't expect perfect control right away, but the day 2 readings are much lower so that's a good improvement already!

Hopefully the nurse will explain carb counting and correction doses to you and your daughter soon, I think they don't go into too much detail at the start, or else it would be information overload!

 

[cugila]

One thing to remember is that when you eat......your Bg levels will usually rise post meal.

When you inject Insulin that is designed to lower the levels after the meal. The trick is getting the balance right, avoid hypo's and hyper's, which at the beginning is not easy. Hopefully you will get more answers from the Mom's and Dad's on the Forum who have gone through all this and can speak from experience.......

 

[SophiaW]

It is very early days for your daughter and your diabetes team will probably be tweaking her doses over a period of time to fine tune. Do you calculate the carbs in the food she eats to determine how much Novorapid to inject with each meal?

In theory you want her reading 2 hours after eating to be slightly above her pre meal reading. Novorapid insulin is active for around 4 hours (it varies from person to person, some it's a shorter period and others it will last longer). After about 2 hours the Novorapid should have peaked and start to tail off. If her reading 2 hours after eating is slightly above her pre meal reading then that is good, from 2 hours to about 4 hours it may fall slightly more but not too much. This will result in her reading before the next meal to be around the same as it was before the previous meal. That's the theory but in practice it doesn't always work that way, but that's what you're aiming for.

A possible reason for her reading climbing higher from the 2 hour post meal to before the next meal might be that her basal is not correct and this might need to be altered/increased. Speak to your nurse or consultant when you see them next and raise this concern.

If her reading 2 hours after eating is lower than what it was before eating, then this could indicate that her carb ratio for that time of day needs adjusting. I think you have a perfectly valid point about worry that a hypo might result if her readings are lower to start with. Many people have a different carb ratio for different times of the day. My daughter is 1:10 for breakfast, 1:16 for lunch and 1:15 for suppertime.

Remember also that exercise will affect her blood sugars so if she exercises that may reduce her blood glucose more quickly and she may need to inject less at the previous meal before exercise, or eat a carby snack before exercising to cover the exercise.

If you don't already have it I highly recommend a copy of the book "type 1 diabetes in children. adolescents and young adults".

 

[stoney]

Hi shellyk

Would just like to welcome you and say hello. I have a 13 year old Son 14 in April. He has been diabetic since he was 3 but has only just gone on the multiple dose regime and as you may have read in earlier posts I am still trying to get to grips with it myself so you are not alone. You will find some well versed and knowledgeable people on this forum who have been a great help for me and still are.

Best of LucK