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Timing Problems - Novorapid?

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BoysDad

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I'm having a regular problem with my 10-year-old son. He's Type-1 using Levemir and Novorapid.

I think it may be a timing problem. The symptoms:
1. We count carbs and inject 1u per 9.5g in the evening. He has his Levemir at the same time (10.5u).
2. Two hours after we eat he's about 5mmol & has a 10-12g snack.
3. An hour after the snack hes running low - often about 3mmol.
4. I have to give him 3 dextrose tablets to keep him up (9g).
5. A couple of hours after this he's good at about 5-8mmol.
6. From then on he rises, often reaching 14 (occasionally more) by the morning.

I'm guessing that the novorapid is working over 4-5 hours but his evening dinner is taking much longer to work it's way through - sometimes up-to 10-12 hours.

Any thoughts on this please and any ideas about the kind of meals i could give him that would more closely match the novorapid profile?

Thanks in advance ...
 
It could happen for a variety of reasons, but most probably It could be that the ratio of novorapid at the meal time is too much and the levemir not enough. The only way to check is to do some fasting tests. Try and give some non carb foods around tea time and then do some hourly checks from then onwards. You may need to do several through the night as well to establish whether the levemir dose is ok. Once you have the basal correct it will make the meal time ones easier to work out.
 
forgot to ask what he ate for his dinner as some foods like pasta and pizza can take a long time to be digested, especially large quantities. This may also explain the low after 2 hours and then the steady increase after.
 
Hi Boysdad, we are going through the same thing with my daughter at the moment. She was being given her novo rapid at dinner time and also her Levimir. Then she was having hyos before bedtime every night. This was partly due to low gi foods like pasta etc which we xepect. But the DSN has made us split the novo rapid and the Levimir. She says that you should not give your basal until at least 1 and a half hours after the bolus. So we have now had to start getting her out of bed to have her basal. We also upped her dinner ratio just by 2 so she would get less insulin. They said try one thing at a time and see which works best. Hope this is some use.
M
 
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