what suppers??

[nicolaknight86]

help!!
my daughter is t1 and 4 years old, shes on novorapid and glargine but im really struggling with night time sugar levels, we have fantastic levels in the day! she goes to bed with lovely numbers 5,6 ect but her sugars soar! we know why, because her glargine isnt injected til 10 pm so she has absolutley no insulin in her body! but she has to have a supper between 10-15g carbs otherwise she hypos early hours (last wk 2.4 at 11pm) and that was with an 9g supper!
anyway we have tried toast, yoghurt, biscuits ect
our dsn wants us to percivere as her levels are really good all day and has reccomended trying low gi foods, anyway any suggestion at all?
her last Hba1c was 9! and its only since checking her bloods at night at different times that we have found the highs and really want to address these!

 

[donnellysdogs]

Does your daughter have one glargine injection a day at 10pm?

 

[nicolaknight86]

yes our dsn says they wont split the glargine and dont want to change her to levimir

 

[donnellysdogs]

Is it every night that the levels go higher or only after a hypo?...only asking this bit, as highs after lows can be due to overtreating a hypo....I have seen postings here saying that some children have as little as 1 glucotab......

What time are your daughters levels starting to soar?? Is it from 3am onward? Has your DSN discussed Dawn Phenomen with you?

I can see why your daughter has a snack before bed, but I will have to hand ideas over for other such snack ideas to other parents.....

 

[nicolaknight86]

they soar from 9-10ish, they do come down she has good morning levels too 4,5 ish
Its not after hypos, but you are right to question this, she only has a small apple juice for hypos which is 8g and a cheddar another 3 g but this is not normally evenings!
she only hypos at night if she has no supper or carb free, I have never heard about the dawn phenonomen though?

 

[Jen&Khaleb]

My son has split Levemir and when it is right we avoid most of the night problems you mention. I think because our kids are little we often need to tinker with the dose but it seems adults need to do this kind of maintenance on a regular basis also.

I don't know that low gi foods will be your answer as ultimately carbs are carbs. Even a feed of hommus or baked beans would probably still mean a hypo and then high in the morning. I don't consider anything that happens after midnight to be food controlled.

Why don't you try and push your GP to try Levemir or is there some reason (hopefully not drug company kickbacks) that he wants you to stick with Glargine?

I have been reducing my sons Levemir at the moment as he had a 2.8 the night before last. I checked him twice last night to find him at 6.7mmol at 1.30am and 4.6mmol at 3am. I fed him at 3am (10 gm carb) and he woke at 14mmol this morning so I guess he would have been fine without me giving him carbs. I'll retest again tonight and then hopefully be able to sleep at night. Sometimes I just think it is that they have woken up that makes the sudden rise in bsl. I will say that Khaleb was awake at 3am and I didn't have to wake him to feed him. Had he been asleep I may have just retested again later but I took the easy way out.

 

[slimtony]

Hi nicolaknight86,

Splitting the Lantus work for me when I had this same problem. Levemir worked better still.

I wonder why your DSN is so against it?

 

[nicolaknight86]

thanks for your input, we dont see our GP for jazmins diabetes as she is so little we are at clinic seeing the consultant every 3 months and we see the dsn at least every 2 weeks or so!
Ive asked repeatedly about levimir but they really dont seem to want to use it at our clinic and the very few children who are on it only have one dose a day, they do not split it!
Im at clinic again in 2 weeks so Im gonna try to push for it, also a pump! which my clinic has just started using as this would eliminate this particular problem also. We have also had to do a lot of tinkering with her ratios too, she has different ratios now at home to at school and she normally only has 1 -1.5 units of novorapid in the morning which is working out perfect! As she has gotten older she actually is needing less insulin, im putting this down to her activity levels!

 

[Jen&Khaleb]

I've had Khaleb being on less insulin lately. A big part of this was me taking him off the bottle but he is also a bit more active. It is Winter here also and he may be burning a few more calories keeping warm. I've had a few hypos when he's come out of the bath of an evening. It is only about half an hour after dinner so seems a bit ridiculous for him to be hypo. I will change my routine all the same. I'll give him his supper before his bath.

I also think the growth spurts really change his insulin use. He sometimes needs a few corrections at strange times and also have some low bsl's, out of the blue. Khaleb is really hungry at the moment.

If you need to promote getting a split long acting insulin to your clinic I would have to say one of the biggest advantages is on the day they get sick and you've got 2 chances to either increase of decrease the background insulin and avoid some of the nasty things that happen with illness. It is also good on really active days when you can reduce the night dose and avoid the 2am hypos. Don't know if these things have ever been an issue for you but the split helps us a lot in these situations.

 

[annettekp]

Hi

My son is 3 and on novorapid and a split levemir and it works for us.

I know absolutely nothing about glargine but could you change the time of your glargine injection to earlier? Is there a reason it has to be at 10pm?

Annette

 

[Spearmint]

they soar from 9-10ish, they do come down she has good morning levels too 4,5 ish
Its not after hypos, but you are right to question this, she only has a small apple juice for hypos which is 8g and a cheddar another 3 g but this is not normally evenings!
she only hypos at night if she has no supper or carb free, I have never heard about the dawn phenonomen though?

If her levels soar from 9-10pm but are back to normal by morning, maybe she needs the insulin before 10pm so it starts working before she rises???

I could be completely wrong with that suggestion though as i am new to MDI and my daughter has Levemir, i had similar issues to you and doing that nightly injection earlier seems to be helping.

 

[nicolaknight86]

hi, she has to have her glargine at 10pm because it doesnt last the full 24 hours and her sugars were very high at tea times, this was a change made last time we were at clinic and has really helped with her late afternoon/early evening levels so it really does have to be as late as possible

 

[nicolaknight86]

glad this amuses you!

 

[Jen&Khaleb]

I've just started making Khaleb some Polenta mixed with a bit of fruit or yogurt for supper. This has been quite a winner for low GI. I had found a baby food made with polenta a few years ago and it was great but discontinued. It is only now I've decided to start making it. I've been making a lot of Khaleb's food these days. Has the price on your supermarket shelves got awfully expensive in the last year or so?

 

[nicolaknight86]

yeah it really has! shes been having low fat yoghurts with fruit for the last few nights and not had as high readings! up to around 12ish but massive improvment, may have to avoid bread for a while, also she cant have the childrens yoghurts as they just shoot her sugars really high!

 

[Jen&Khaleb]

I don't think children's yogurt is really for children. The ones here don't even contain fruit and are just fruit flavoured and full of refined sugar. I buy a locally made yogurt and it has 12gm carb/100gm and is free of artificial ****. It tastes really good (creamy) and is not sour at all like some natural yogurts.