I can’t remember the last time we had a 400 even so to get over 500 today was really worrisome. He had some “mini hot dogs”…the kinds that are in a roll and are baked/microwaved. He had had them before, but only 4 at a time (1 serving)…today he wanted 12 of them. 72 carbs total…I gave him 1.5u up front then figured loop would take care of the rest. It DID…but only the amount based on our I:C, ISF, etc.,
When he got up to near 300 I gave another 2 units because it was double up and was still moving fast. I waited another 40 minutes or so and he checked them and found out he was…540. WTH!!! We haven’t seen a 400 in ages much less a 500…probably 3 or 4 years.
So I immediately changed his POD and gave ANOTHER 2 units. Then, as you can see from the image below it coasted around 540 for another hour…I checked his ketones twice throughout and he was only .2 and .3 so no worry for ketones…so he just drank a lot of water, stayed relatively inactive and we let the insulin finally do it’s thing.
Take away for me from this (maybe someone can see another take away)…this particular food may need a double or triple bolus when he’s consuming so much at once. When he has only 4 I don’t see any reaction at all but 12 might have been too much to give a regular bolus for.
Anyway, just sharing because it’s not always rainbows and butterflies! But he took it in stride…he’s actually old enough now to “remember” this as his first 400/500 and he’s really excited about it. lol. He’s like…WOW! This is crazy! I’ve never been this high! I’m like…you have, but it’s been years…you wouldn’t remember the last time. So he’s just chilling and waiting for them to continue dropping.
We will let this just roll off of us because it’s going to happen. I’m trying to teach Liam to not stress over these kinds of things…just do what you know you’ve been trained to do, control what you can control and trust the science. Teaching them to not worry and stress when these things happen, I believe, will set him up to not become mentally burned out when he’s doing this by himself later in life.
But you get used to it (kind of). Today, I had a bagel for breakfast, and only took 5 units to start. Good thing, an hour later I was at 40. Drank juice and ate a big cookie. Went up to 70 before it crashed again. Had more juice and another cookie, 1/2 a sandwich and a piece of fruit. Two hours later I was 106. Two hours later it crept down to 50, so I ate a dinner of Creole shrimp over rice (no insulin) and now, an hour later it’s 93. About 300g carbs, 5 units of insulin. ( my C:I is 3).
Only one thing is for sure: Diabetes is weird. Hope Liam is feeling better.
Just when you think you’ve got it all figured out… Glad that Liam handled it well (you, too @ClaudnDaye). Also glad that you weathered today well, @docslotnick. Cookies…but no donuts? .
I thought most of them showed HI when over 400. Interesting if current meters go over 500!!
In my early days, I had quite a few HI readings, or dark orange/brown on urine tests in test tubes.
Thanks for sharing - very interesting. I am sure it will happen.
Twice Audrey has had regular pasta and regular ritz crackers instead of wholegrain which caused unexpected spikes. Over-corrected with Humapen to belly (MDI) both times and gave her cool flavoured water which we usually keep for highs as she drinks it very quickly. I think 360 was the max reading.
Not saying it wasn’t only the food, but that seems like a crazy response “just” from 72 g of carbs. If that happened to Cody I would say that he also had a site problem. Congrats on going 3-4 years without another 500.
I thought it was a sight problem also which is why I changed the POD immediately once we checked that #. But as I said after changing the site it sat there at 540 for another hour. A site problem, once fixed usually nearly immediately (for us anyway) starts going down.
Next time he has 72 carbs of THIS food, we’ll double the bolus and see what happens. In our house, it’s all about figuring it out…no sense in not letting him enjoy things. We just have to figure out how to bolus for those crazy foods so that he can enjoy them if he wants.
Sometimes it’s just a perfect storm. Like it wasn’t just the food, but maybe several things happening all at once. Bad insulin absorption plus hormones plus a BG that was going to be moving up anyway even if you didn’t eat, plus maybe some reduced basal in the time preceding the meal. Who knows what all was involved?!
Maybe just a bunch of things together. And when all of those things coincide, things can suck quickly.
Try those mini-dogs again sometime when everything seems solid, and be more aggressive with the bolus, and you will conquer it.
Sounds like it was handled well, and good to model that it’s just something to deal with, since unlikely to be the last time!
In my experience, a single food-driven high rarely causes ketones, nor should it theoretically. Ketones are much more likely to occur from highs from inadequate basal insulin (site problems, sickness increasing basal needs and not adjusting to that, etc) than inadequate bolus insulin, as long as someone has had at least a decent amount of food recently that was adequately covered by insulin, so they aren’t functionally starving.
Totally agree, but from the parents’ perspective those checks were more for my peace of mind. lol. Anytime I see that severe of a high number I want to make sure there’s no DKA threat and the Ketone check confirms that for me which helps me calm relax a bit and trust the science.
Unfortunately with the high growth times ahead there will be more 500’s, but likely the headaches will come not from diabetes but from normal child raising issues. The only one that crossed the lines into both for me lately was the lying/driving without a blood sugar check.
Idk - there are certain foods that seem to create intense spikes in blood glucose. For me, it’s pretzels - bagels are bad too. I try not to eat them - and while I love bagels I do eat them occasionally, but now try to eat half a bagel rather than a whole one.
Of course the other thing to do is exercise - especially if you’re running that high. So I’m curious as to why you wanted him to stay calm when his blood sugar was that high?
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In our house, it’s all about figuring it out…no sense in not letting him enjoy things. We just have to figure out how to bolus for those crazy foods so that he can enjoy them if he wants.
