Blood glucose control in new-onset Diabetes (type 1)

[iriss]

My 17 yr. old sone was diagnosed with type 1 diabetes 3 weeks ago and already wears an insulin pump.  His sugars seem difficult to control.  He can have blood sugars of 100 and then it shoots up to 180 after a meal (which I think is too high..even if the ADA thinks it's fine).
Yesterday and today the basal rate had to be lowered because his sugars were in the 60's and 70's (even though he had not hypoglycemia symptoms).  So, today was fine..he was in the 80's all day (before and after meals).  But, 3 hours after dinner he was 178!  Is it possible to maintain an even reading most of the day..for example, is it possible to stay between 80-115 all of the time??  Basically his numbers range from 70-180..without any particular reason. Does the sugar stabilize at some point?
Thanks

[JDRF-Team-BL]

Dear Sharon,
    It is quite impossible to keep blood sugars between 70 and 120 no matter how hard you try. The ADA has said that two hours after a meal the blood sugar should be below 180, because even the body of a normal nondiabetic will have blood sugars after a meal go to 140. And also that ADA recommends that to also prevent low blood sugars, which i have had some severe ones myself lately and the last one i was brought to the local emergency room, and the ADA has in studies found that those who attempt to keep normal blood sugars have three times as many low blood sugars than a diabetic on a slightly looser regimen. Also having frequent lows can bring on hypoglycemia unawareness, where the diabetic has no physical warnings of an impending low. i found out about this the hard way by driving my car in such a state and i lost a leg in the car accident and haven't driven a car since then because i don't trust that i wouldn't do it again. Because i did check my blood sugar before i drove my car in the accident and on my meter it was 34 as the doctors showed my wife afterwards. And the Joslin Clinic afterwards recommended i keep my blood sugars between 150 and 180. Hope this helps, bret

[Shotokan]

Your son is doing very well!  You should give him lots of encouragement.  It is unreasonable, at this early stage, to ask him to achieve perfect control.  He is already under enough stress coping with this new disease.  If you insist on perfect BG readings, it will only add to his stress, and stress can cause higher blood sugars.

Normal blood sugars in non-diabetics reach 120-140 two hours after a meal, depending on how glucose is measured.  Also keep in mind that BG meters and test strips are not perfectly accurate.  If you take two measurements just a minute apart, you will usually see a difference of at least a few points, and often more.

Also, at this early stage, you should be at least as worried about low BGs as you are high BGs, especially at night.

I know you want the best for your son.  Just relax, especially around your son, and have a little patience!

[iriss]

Thanks for your responses. I'll try to relax a bit. It's just that this disease is so scary. I am a registered nurse and I am much more afraid of complications down the road than I am of hypoglycemia.
All I can say is..thank goodness for the pump!

[Markie]

Sharon,

Your son is most probably still in the "Honemoon Phase". Which means that the pancreas is still producing some insulin. The problem is that it does this intermittently, resulting in unpredictable blood sugar swings.

During this time, it is expedient to reduce the basal rate somewhat to avoid lows at night and between meals. Concentrate on infusing enough insulin when it is neede most - at mealtimes.

Cheers,

Mark