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Diabetes - Juvenile Community
This patient support community is for questions related to juvenile diabetes including celiac disease, depression, diabetic complications, hyperglycemia / diabetic keto-acidosis, hypoglycemia, islet cell transplantation, nutritional issues, parenting a diabetic child, pregnancy, pump therapy, school issues, and teens with diabetes.
9 year old newly diagnosed with type 1
by jalyn, Oct 01, 2007 12:00AM
just found out my son has type 1, he was in the hospital for a week with out of control bs levels of over 500. he works on a sliding scale and carb count for his insulin and gets 15 mg of lantus everynight. i am still having alot of trouble with his high bs at night. i have that stupid fear of giving him to much insulin and then he gets lantus. i guess the ? is , is there any problem with giving him those 2 too close together and if his bs still seems up after a insulin shot and lantus, do u just keep giving more until his bs goes down? and my son loves to eat and doesn't ever seem to want to take a break so its really hard to manage giving him insulin for every little thing he puts in his body, any suggestings would be great and i am trying all the no carb snacks. this is all so confusing to me so whatever help anyone can give me would be great
Doctor's Answer
by JDRF-VOL-SG, Oct 02, 2007 12:00AM
Once the blood sugar levels are under control, his appetite will slow down some, so hang in there. He is hungry when glucose levels are high because his body is starving for those carb sugars that aren't being converted properly into energy. Hence, he craves food. This will be better once he is under control.
The high levels at night are probably happening because the evening Lantus is not truly lasting 24 hours. See if this makes sense to you... Lantus is marketed as a 24-hour insulin, but it doesn't work full force for exactly 24 hours and then -- poof -- suddenly quit. If you read the paperwork in your Lantus box, you will read that it lasts anywhere between 20-24 hours. It seems to peter out sort of slowly sometime in that time frame, leaving very little Lantus working to help with his dinner-time quick-acting insulin. So it may take more insulin in the evenings than at other mealtimes to cover the same amount of carbs.
Some of us prefer to split the Lantus dose, taking some in the morning and some in the evening to equal the complete dose. That way, only half is petering out after 20 hours, and the sugar levels stay more even throughout the day.
The Lantus shouldn't work quickly, for it crystallizes in the injection site and slowly dumps tiny bits of insulin into the body all day. So the quick-acting insulin is what you want to use to lower a high reading. You need to wait about 2-3 hours after the quick-acting insulin is given, though, before adding more, for it may still be peaking in action and you don't want to overdose, especially at night. Frankly, if in doubt at bedtime, I think it is safer to err on the side of slightly high than low, for lows in our sleep are very dangerous.
I hope this helps educate you some. I love the Lantus insulin, and the great control it offers, in conjunction with quick-acting insulin at mealtimes.
The high levels at night are probably happening because the evening Lantus is not truly lasting 24 hours. See if this makes sense to you... Lantus is marketed as a 24-hour insulin, but it doesn't work full force for exactly 24 hours and then -- poof -- suddenly quit. If you read the paperwork in your Lantus box, you will read that it lasts anywhere between 20-24 hours. It seems to peter out sort of slowly sometime in that time frame, leaving very little Lantus working to help with his dinner-time quick-acting insulin. So it may take more insulin in the evenings than at other mealtimes to cover the same amount of carbs.
Some of us prefer to split the Lantus dose, taking some in the morning and some in the evening to equal the complete dose. That way, only half is petering out after 20 hours, and the sugar levels stay more even throughout the day.
The Lantus shouldn't work quickly, for it crystallizes in the injection site and slowly dumps tiny bits of insulin into the body all day. So the quick-acting insulin is what you want to use to lower a high reading. You need to wait about 2-3 hours after the quick-acting insulin is given, though, before adding more, for it may still be peaking in action and you don't want to overdose, especially at night. Frankly, if in doubt at bedtime, I think it is safer to err on the side of slightly high than low, for lows in our sleep are very dangerous.
I hope this helps educate you some. I love the Lantus insulin, and the great control it offers, in conjunction with quick-acting insulin at mealtimes.
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Of course, I am not a doctor but when you are a mother of a diabetic sometimes you know more because you live with child. Every kid is different but maybe this could help if you brought these ideas up to your dr.