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Why why why ?

S

stoney

Well-Known Member
Messages
321
Location
South Wales
Type of diabetes
Parent
Treatment type
Pump
Can anyone tell me WHY James ALWAYS has a high BG on Saturday mornings before going to play football.

Typical examples

Before Breakfast Football Before Lunch
17.1 17.6
14.2 19.4 14.0
14.1 10.9 5.8 (this match was called off)
Today 12.8 19.9 at 12.15 was 17.2 had a bath and 13.05 was 8.3

The rest of the week at school his control is very good but come Saturday morning :?

I can only think that he is soooooo into his football that it is an adrenalin rush.

His DSN said to take some sips of Lucozade before playing to see what happens as he is already high anyway. WELL THAT DID'NT WORK

Any suggestions :roll:
 
Do you test for Ketones when he is that high ? Normally exercise at levels above around 13 mmol/l is NOT recommended by any HCP's as the levels can frequently soar.

Why would you be told to give him Lucozade (fast acting carbs) before exercise when his levels clearly need to be much lower. Lucozade will increase the levels ! Seems very odd to me ?? :?

Do you test his morning levels immediately on waking ?
 
No we don't test for ketones unless he is unwell.

I don't know why the DSN said to take sips of lucozade before playing (is it cos the insulin would kick in sooner).

James always tests as soon as he gets up
 
Thanks for that.

I am no expert on Kids Health but I do know this :

Do the following with any high blood glucose levels:

•Test for ketones if the blood glucose is above 15 mmol/l.
•If the blood glucose is above 15 mmol/l and there are ketones present- extra insulin is needed (see section 10 ‘Sick days ’).
•If the blood glucose has only been high for a short time and there are no ketones- all you need to do is observe the situation and check the blood glucose later to make sure it falls.
•Some families give small extra doses of short—acting insulin whenever blood glucose levels are high- and then check the blood glucose levels afterward to make sure it is satisfactory. Be very careful of giving extra doses of short—acting insulin before exercise- in the evening- at bedtime or overnight this should generally be avoided. Many find that extra insulin is not necessary for the occasional high reading and the blood glucose falls satisfactorily without any extra treatment.
•Drink plenty of fluids when the blood glucose is high-water or diet (sugar—free) drinks. This helps to lower the blood glucose and prevent dehydration.
•Try to identify possible causes (eg- illness- others as above).
•Look to see if there is a pattern of the blood glucose rising at the same time each day in this case an increase in the appropriate insulin dose should be considered.
•Consider whether there could be a problem with food intake.
•Avoid strenuous exercise if the BGL is high- especially if ketones are present. If the body is lacking in insulin- exercise will not bring the BGL down (see more information in section 10 "Sick days" and section 11 "Exercise and sport")
Click to expand...

This is a link to a Diabetes Manual for Kids which is Australian but is very good.

http://www.rch.org.au/diabetesmanual/ma ... oc_id=2741

There isn't a great deal of difference to UK ideas. As you can see, high levels are the time when you should always test for Ketones, matters not that he feels OK. Exercise is definitely not advised with the high levels. I really think you discuss this carefully with your DSN.......there is maybe a problem with diet and or Insulin levels which needs addressing. He shouldn't be having such high levels and they need investigation to find out the cause.

I hope we can get some responses from other Mom's and Dad's today. They are better placed to answer as to what you should do and possible reasons.
 
I have moved it into the Youth Club section where there may be more replies.It is now in Type 1 AND the Youth CLub.

As for the Lucozade.....that is for elevating the BG levels.......it will require MORE Insulin to counteract it's effect. It is sometimes used to treat a Hypo.......it will exacerbate Hypers ..... :(
 
When you say his weekday readings at breakfast are normal can you give us some examples? What reading would he typically wake with on a weekday?

Is there anything he regularly eats on a Friday night which might affect his blood sugars overnight? For example, my daughter will wake with a high reading the next morning if she has eaten pasta, pizza or a high fat food like takeaway fish & chips. Her bedtime reading will be good but by the next morning her readings are high because they have steadily increased from the early hours of the morning. With the pump we can combat that now but on MDI we struggled. Could something like this be causing the Saturday morning problem? High protein meals can have a similar delayed affect on blood sugars.

You could be right that an adrenalin rush could be causing the spike. It might be helpful if you started testing hourly from 3 or 4am on Saturday morning to try and identify exactly when the spike begins. If he's got good readings up until waking but then spikes then that may confirm that the excitement of the coming football game is causing a problem. If you can identify when the spike starts you can give a correction injection early so that by the time he gets to football he can start the game with a reasonable blood glucose level.

With a high reading it's not advised to take part in exercise if he has no or very little insulin on board. If he's recently taken a correction for the high reading then exercise can aid in the insulin working more quickly and his readings returning to a more normal range more quickly. But if he is unwell then he should never take part in the game with elevated readings.
 
we had this problem until we moved to a pump now he has perfect blood sugars throughout the match, we tried loads to sort it but have to say never tried lucozade lol

anna marie
 
I find that my son needs more insulin at the weekend than he does during the school week. Not sure why as he is quite active on a Saturday. My daughter however has the same insulin to carb ratio at the weekend as she does in the week. Not sure why this is, just another thing to figure out about diabetes in children!
 
When I was at Camp Diabetes not very long ago a sports dietician who specialises with sport and diabetes gave us a talk.

One of the reasons they are suggesting giving fast acting carbs is because the excitement of the match causes kids to liver dump lots of glucose and later on in the afternoon or evening many parents experience hard to treat hypos as the body wants all that glucose back. I have experienced this after really big days out. If the game wasn't cancelled maybe you would have got a better idea of what giving the fast acting carbs would do and if it would help with the levels or not. On the talk I attended it wasn't suggested using lucozade as this type of thing will just end up rotting all their teeth and a small muesli bar or an apple was a better option.

If the game had gone ahead do you often have hypos late in the afternoon/night or the next day?

It was an interesting theory and the idea was to ignore some of the high figures (not when ill) before and for a few hours after exercise as this is when the body was absorbing large amounts of glucose for stores. It is still a trial and error thing with kids and sometimes diabetes never follows the path of research anyway.

With the test results you quoted had you really done 8 tests before lunch or was that all day?
 
Thanks everyone for the replies.

The BG's I quoted were for the three saturdays in a row since he went on MDI. Looking at the pattern now he does tend to drop quite quickly 2 hours after lunch.

We have been thinking over everything and wonder if it could be that since it's Friday and he goes to bed a little later, he does not finish his supper which is the same every evening until about 9.45 p.m. and has not actually done the Lantus until an hour later, just before bed at 10.45 which he normally does around 10p.m. weekdays. He also gets up on Saturday morning 3/4 hour later than on school days. What do you think :?:
 
You may have solved at least one of your "Why's?". The other 2 might always remain a bit of a mystery. My son always runs a little high on daycare days because I tend to feed him a little extra and give his insulin a little later. I think I'm just working on the better-safe-than-sorry principle. I didn't even think I was doing this until I had a close look. Khaleb was hypo last night because I put up his Levemir because he was too high. The first night I put it up it he was perfect but the second night he was hypo. 6 units is not quite enough and 6.5 units is too much. I wonder what would happen if I gave him 6 units one night and 6.5 the next and then back to 6 units ???
 
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