Upset Son - Need Support

Matthew's parents I assume? It might create less confusion if you make another username, but you don't need to if you don't want too, if you sign your posts I'm sure everyone can work it out
Who told him not to inject before meals? When did they tell him to inject instead? What insulins is he on? Can you give some example blood sugar readings eg fasting, 2hrs after meals.

Firstly, you and Matthew shouldn't be worrying too much, as he has recently been diagnosed it will take a while for him to get a hang of everything, that's normal.

Is he testing for ketones when he has high blood sugar at the end of the day?

Have I got this right: he was on lantus, and humalog (with meals), and now the nurse has said to stop the humalog, but continue with the lantus?

2.9 is far too low (did he have symptoms of the hypo?), maybe this is why the nurse said to stop the humalog, she probably wants to see how his blood sugar levels are without it.

Maybe he needs some insulin with lunch and evening meal but not with breakfast at the moment. I'd suggest you ring the nurse tomorrow and ask her about this.

With such small amounts of insulin a pen that does half units would probably be good.

HI,
Type-1s cannot manage with a long-acting insulin alone, if you're son's diabetes nurse had any education in diabetes management, she should at least know that, it's basic knowledge. The numbers you have given when he was taking when taking the Humalog were good, apart form the 2.9 at lunch. Had he done any physical excercise after breakfast?
You haven't mentioned what you're son had for his meals, if these were carb-based that would cause a rise in BG and perhaps explain the further increase throughout the day. Another theory is that Lantus, although marketed as a 24 hour basal insulin, does not always work that way for many people. In such cases it can make it virtually impossible to find a pattern/explanation to what is happening re-BG levels.
The results your son is having without Humalog are too high after meals, so leaving out just the breakfast humalog may solve the lunch hypo. It sounds like you and your son are doing everything you can to try to control things, so don't beat yourself up, it doesn't sound like you're doing anything wrong. Your son's diabetes nurse is probably being extra cautious as he's on very small doses. She might also be watching for the "honeymoon period" which occurs after diagnosis, when the pancreas relaeases it's last stores of insulin again for a short period of time, usually a couple of weeks. During this "honeymoon period", the patient may need no insulin at all. This can occur many months after diagnosis, mine happened 9 months after diagnosis and I was on no insulin at all; thought I was cured LOL That was 21 yrs ago.
It would help if we had more info about your son's diet, particularly carbohydrate amounts and activity. The effects of physical exercise can keep BG levels down for a few hour after.
It takes time to adjust, and occasional high BGs at this point will are unlikely to cause your son any permanent harm. It's best to put them down to experience and not dwell on it too much, although the ups and downs will make him feel a bit lousy, hopefully on the correct insulin and dosage that will resolve to some extent. Unfortunately type-1 diabetes is always a balancing act, we just get better at it over time.
Jus

HI, sorry I had to edit that post a couple of times, after re-looking at your son'S BGs.
I used to skip, and sometimes still do, the breakfast dose if I'm going out for a run or am particularly active in the morning. Sometimes we do things that work for us, but the diabetes clinic don't always agree with our methods
let us know how things go
Jus

Hello Matthew's Mum and Dad

I think Matthew would probably be much better off bg wise if he were to inject the Lantus twice a day and split the dose accordingly. It looks as though Lantus is having too much of an inpact at the wrong times as the dose is injected in one go. If the Lantus was injected in split dose twice daily 10-12hrs apart the change in bg levels would be a bit smoother and not so up and down. Humalog can then be adjusted a bit better to cope with what Matthew eats and also what exercise he plans to do. Sometimes its easier though to just eat a carby snack before exercise and not worry about reducing insulin especially if you're not sure how much you need to reduce :?

Matthew has started many threads on the forum mainly about how to calculate insulin to carb ratios and loads of people have recommended that he do a DAFNE type course. I think he said that he will be going on one sometime over the next couple of months but in the meantime it might be worth him looking at a thread that I took part in about carb counting where I and a couple of others tried to explain how to go about calculating carb ratios to a newbie person.

Look at the link and then print it out. It's sometimes easier to figure out what to do when you've got the instructions in front of you.

viewtopic.php?f=19&t=18553

Lilly do a 0.5unit insulin pen for Humalog and Lantus called Humapen Luxura HD. It's dark green in colour so Matthew would have to stick some tape or use felt tip pen on one pen so that he doesn't get confused as to what insulin he is using.

Hi again,
I'm surprised your son is not recognising hypo symptoms so soon after diagnosis, have you mentioned this to his diabetes nurse?
Jus

Hi Matthews Mum and Dad,

I just wanted to add, that you really do not need to worry at the moment. He is so new to the whole diabetic thing, and is still in eth honeymoon period, where his bosy is still producing some insulin etc. It is always difficult to manage this...and the fact that he, and you are asking all these questions, and doing everything that you are doing is a fantastic sign. OK, if this goes on for months, then he needs togo back to teh nurse..but it really isn't unusual to have a few highs and lows at this stage...as long as he is treating them. It is like learning to drive...you stall quite a lot, but as long as you act calmly, put the car back inneautral, and then start again, nothing major happens. As time goes by, you stall les and less...although it does still happen. Keep in close contact with the nurse..perhaps suggesting that if his BG is over, say 6, before a meal, then he dhe has some Humalog, and if it is below 7, not do it. Over time, and for some this can be a year, his insulin requiremnts will increase, as he comes out of the honeymoon period.

take care

janabelle said:

I'm surprised your son is not recognising hypo symptoms so soon after diagnosis, have you mentioned this to his diabetes nurse?

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I'd second that, you need to speak to the nurse about this. Does your son drive?

Has he informed the DVLA that he is hypo unaware? He needs to do this right now (or whenever their phone lines open), and stop driving. It's irrelevant that he tests before he drives, blood sugar can drop quickly and meters can be faulty.

If he can't tell when his blood sugar is at 2.9 he is hypo unaware. It should be very obvious to him that it is at this level, he shouldn't need time to recognise the symptoms.

I know two people who have caused accidents because they thought their 'right' to drive was more important than other people's lives. Both had health problems that meant they were unsafe to drive, but drove anyway, because they were selfish idiots. One caused severe brain damage to a child. The child will never recover.

It may be possible for him get hypo symptoms on different insulin, so he may be able to drive again in future, speak to the nurse about this she should be able to help.

Hi

As long as he remembers to always test his bg level before jumping behind the steering wheel and make sure that his level is about 8mmol, then he should be able to drive ok with safety. Many people don't always realise how fast bolus insulin in particular can make bg levels drop depending on the time of day they are driving, so a safe bet is: before a meal is due is a no no but after a meal is a yes yes.

In real life every insulin dependant person will at some stage or another have low bg levels that go down to below 3 before their awarenes kicks in. It doesn't mean that they should never drive. What it means that they should be very careful, test their bg level, make sure their level is at least on 7 or 8 and have some sweets on the dashboard so that they can suck a few, concentrate on the road ahead and not worry about going low.