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Newly Diagonosed Strang BM Readings
My 10 year Daughter has been very recently diagnosed with type 1 diabetes. We were discharged from hospital tonight.
At bed time she took her glcose and it was 25.4, I decided to redo it an hour later and the meter said it was hi over 27.8, re did it at got the same reading. I phoned the childrens ward and they were very unhelpful. Any advice. Thanks
At bed time she took her glcose and it was 25.4, I decided to redo it an hour later and the meter said it was hi over 27.8, re did it at got the same reading. I phoned the childrens ward and they were very unhelpful. Any advice. Thanks
Dear sewing_pirate,
I was so glad that you responded back so quickly and am so very happy how well your daughter is doing. You really got hit with very many questions, suggestions and responses. Along with others, I had a feeling she had just been recently diagnosed but I have to admit that a few hours was a bit of a shock. You are doing great to have the fortitude to reach out for information this quickly and I applaude you for this.
When our children are first diagnosed, we have so much to learn immediately. It is a lot to take in. Please always feel free to contact us at anytime. We are here for you.
Wishing the best,
dm
I was so glad that you responded back so quickly and am so very happy how well your daughter is doing. You really got hit with very many questions, suggestions and responses. Along with others, I had a feeling she had just been recently diagnosed but I have to admit that a few hours was a bit of a shock. You are doing great to have the fortitude to reach out for information this quickly and I applaude you for this.
When our children are first diagnosed, we have so much to learn immediately. It is a lot to take in. Please always feel free to contact us at anytime. We are here for you.
Wishing the best,
dm
Sorry I didn't say I did check her urine for keytones and that was fine and still is.
Thank you everyone, I will try to answer everyones questions.
When I said she had been recently diagnosed with diabetes, I was talking hours rather than weeks.
On Monday I took my daughter to the doctors as I was concerned about her losing weight, drinking alot and being tired. The doctor did a load of routine blood tests and left it at that. We went out Monday Night, returned home to find an answerphone message to phone the emergancey doctor. When I phoned back they said they wanted to admit her to hospital straight away. Within an hour we were in hospital. Her blood Suger had beeen 31.8 mmol/l. All through the night they constantly tested her, and at about 3 am they announced she was diabetic. She spent Tuesday in hospital, meeting the peadeatric diabetic team, learning about blood tests, and injections, and diet. She was discharged Tuesday evening, and that is when I posted my question. She had not missed her insulin as she had this before we left hospital.
The nurse came to see us Wednesday morning before breakfast, and then later that morning.
She has phoned a couple of times as well. My daughter went back to school today (Thursday), and got on really well. Her blood sugars are still a little high arond 16-18 mmol/l (4-10 mmol/l being what they aim for.) Her insulin has been adjusted for tomorrow. She was taking 10 units in the morning and 5 units in the evening, this is increasing to 11 units in the morning. She is taking Mixtard 30. And currently does it all her self, she actually let me do it for her tonight.
Once again thank you all for your help and advice.
When I said she had been recently diagnosed with diabetes, I was talking hours rather than weeks.
On Monday I took my daughter to the doctors as I was concerned about her losing weight, drinking alot and being tired. The doctor did a load of routine blood tests and left it at that. We went out Monday Night, returned home to find an answerphone message to phone the emergancey doctor. When I phoned back they said they wanted to admit her to hospital straight away. Within an hour we were in hospital. Her blood Suger had beeen 31.8 mmol/l. All through the night they constantly tested her, and at about 3 am they announced she was diabetic. She spent Tuesday in hospital, meeting the peadeatric diabetic team, learning about blood tests, and injections, and diet. She was discharged Tuesday evening, and that is when I posted my question. She had not missed her insulin as she had this before we left hospital.
The nurse came to see us Wednesday morning before breakfast, and then later that morning.
She has phoned a couple of times as well. My daughter went back to school today (Thursday), and got on really well. Her blood sugars are still a little high arond 16-18 mmol/l (4-10 mmol/l being what they aim for.) Her insulin has been adjusted for tomorrow. She was taking 10 units in the morning and 5 units in the evening, this is increasing to 11 units in the morning. She is taking Mixtard 30. And currently does it all her self, she actually let me do it for her tonight.
Once again thank you all for your help and advice.
Dear sewing-pirate,
Hopefully, you read this AFTER getting some immediate attention for your daughter. I also want to relate our first experience with our 3 yr. old son, for your reference. I am sad that you are not getting good help/advice from your hospital staff, because our experience has been much more supportive.
We live in Canada in the Toronto area. His dx was at 2 yrs 4 months, and after our pediatrician, we were sent to the Hospital for Sick Children, where he was eventually measured at over 27 mmol/L (=486mg/dL) when he got his first insulin and the HbA1c result we eventually got back showed he was at 9.5% that night. He was immediately on a regimen giving him morning and dinner insulin. The next morning, his blood glucose level was in range at 9.9 and his bed was dry for the first time in weeks.
However, because of his age and size, his endocrinologist was very conservative with his doses, and this reflected in his daily blood glucose readings. For the first few days, he'd be between 12 and 18 in the morning, and often in the twenties the rest of the day. Every morning, we called our diabetes team nurse to relay the previous day's readings, and she suggested changes to attempt to bring him down. Eventually, by the 11th day, his levels were more stable within the 6-12 mmol/L range as prescribed for his age.
The key here is that his ketone levels saw the immediate improvement. With newly administered insulin, the body finally began to process the glucose, and the first effect, as I understand it, is that the by-products of fat & muscle burning (ketones) immediately go down. The high blood glucose readings will eventually subside as the dosages are worked out. He was eventually switched to morning, dinner, and evening shots and that's how we stand now
(FYI:
(1) morning: 10 units (1/30cc=1 unit) of Novolin ge NPH (isophane insulin) mixed with 1.5 units of Novorapid (aspart insulin; Novolog in the US), abbreviated as N10 & RP1.5 respectively
(2) dinner: RP2
(3) evening snack: N3.5)
Even now, we're still just adjusting to the eating and injection schedule, and you will too. It takes time, and we'll never really "get used to it", but it's all we can do for our kids. Our son's last HbA1c check was 7.5%, so, overall, we know that we're doing the right things to keep his diabetes in check.
Again, good luck and, if you're not satisfied with your daughter's Diabetes Team, go to a children's hospital and demand better, and keep in touch with JDRF. This forum's contributors seem to be very helpful and knowledgeable.
Tony
Hopefully, you read this AFTER getting some immediate attention for your daughter. I also want to relate our first experience with our 3 yr. old son, for your reference. I am sad that you are not getting good help/advice from your hospital staff, because our experience has been much more supportive.
We live in Canada in the Toronto area. His dx was at 2 yrs 4 months, and after our pediatrician, we were sent to the Hospital for Sick Children, where he was eventually measured at over 27 mmol/L (=486mg/dL) when he got his first insulin and the HbA1c result we eventually got back showed he was at 9.5% that night. He was immediately on a regimen giving him morning and dinner insulin. The next morning, his blood glucose level was in range at 9.9 and his bed was dry for the first time in weeks.
However, because of his age and size, his endocrinologist was very conservative with his doses, and this reflected in his daily blood glucose readings. For the first few days, he'd be between 12 and 18 in the morning, and often in the twenties the rest of the day. Every morning, we called our diabetes team nurse to relay the previous day's readings, and she suggested changes to attempt to bring him down. Eventually, by the 11th day, his levels were more stable within the 6-12 mmol/L range as prescribed for his age.
The key here is that his ketone levels saw the immediate improvement. With newly administered insulin, the body finally began to process the glucose, and the first effect, as I understand it, is that the by-products of fat & muscle burning (ketones) immediately go down. The high blood glucose readings will eventually subside as the dosages are worked out. He was eventually switched to morning, dinner, and evening shots and that's how we stand now
(FYI:
(1) morning: 10 units (1/30cc=1 unit) of Novolin ge NPH (isophane insulin) mixed with 1.5 units of Novorapid (aspart insulin; Novolog in the US), abbreviated as N10 & RP1.5 respectively
(2) dinner: RP2
(3) evening snack: N3.5)
Even now, we're still just adjusting to the eating and injection schedule, and you will too. It takes time, and we'll never really "get used to it", but it's all we can do for our kids. Our son's last HbA1c check was 7.5%, so, overall, we know that we're doing the right things to keep his diabetes in check.
Again, good luck and, if you're not satisfied with your daughter's Diabetes Team, go to a children's hospital and demand better, and keep in touch with JDRF. This forum's contributors seem to be very helpful and knowledgeable.
Tony
Dear sewing-pirate,
You have been given the best information from so many here. When you have time we would love to hear back from you.I hope all is well and that you may have taken advantage of our sister outreach program, ODST, that I suggested last night. I also hope you had some positive results with her doctors. As a mom, I can't tell you enough what an advicate that you are for your child and we are more than willing to help you every step of the way.
dm
You have been given the best information from so many here. When you have time we would love to hear back from you.I hope all is well and that you may have taken advantage of our sister outreach program, ODST, that I suggested last night. I also hope you had some positive results with her doctors. As a mom, I can't tell you enough what an advicate that you are for your child and we are more than willing to help you every step of the way.
dm
I agree with everyone. Take her to the hospital if the phone support system is lacking.
Another good question that was asked was "Did she miss a shot?"
If my son had blood sugars in the 4-500's and they were not going down, I would take him to the emergency room.
I am guessing she most likely has keytones....
One thing we were taught is that if our son has moderate or higher keytones, to give him 1 - 1.5 untis extra of humaolg. (the fast acting insulin) and have him drink water.
Please let us know the outcome of these highs and yor medical help.
I agree that
www.childrenwithdiabetes.com is a VERY useful website. I have found great tips / ideas there.
Another good question that was asked was "Did she miss a shot?"
If my son had blood sugars in the 4-500's and they were not going down, I would take him to the emergency room.
I am guessing she most likely has keytones....
One thing we were taught is that if our son has moderate or higher keytones, to give him 1 - 1.5 untis extra of humaolg. (the fast acting insulin) and have him drink water.
Please let us know the outcome of these highs and yor medical help.
I agree that
www.childrenwithdiabetes.com is a VERY useful website. I have found great tips / ideas there.
Hi,
If her blood is at 27+ this either unbelievably high (485+) and she needs to be taken to hospital immediately and her blood sugar stabilised, or on the other extreme this could be a level of sub 2 on the normal scale, in which case she is at a dangerously low level. The scale for US to the rest of the world is 18:1 your targets BG should always try to remain within the "normal ranges" of 4.0-9.0 approx (that is 70-170)
pls go back to your doctor/ hospital and do not return until you have understood the ranges and your daughter is relatively stable, I assure you that Diabetes need not be a catastrophic problem, but you need to understand the problem better in order to live with it.
I hope this helps and I sincerely wish you all the best
If her blood is at 27+ this either unbelievably high (485+) and she needs to be taken to hospital immediately and her blood sugar stabilised, or on the other extreme this could be a level of sub 2 on the normal scale, in which case she is at a dangerously low level. The scale for US to the rest of the world is 18:1 your targets BG should always try to remain within the "normal ranges" of 4.0-9.0 approx (that is 70-170)
pls go back to your doctor/ hospital and do not return until you have understood the ranges and your daughter is relatively stable, I assure you that Diabetes need not be a catastrophic problem, but you need to understand the problem better in order to live with it.
I hope this helps and I sincerely wish you all the best
Hello sewing_pirate,
First, I want you to know that I am not a medical professional, so my input/advice is based on personal experience and knowledge from taking care of my son who is living with type 1 diabetes. He was diagnosed almost 7 yrs. ago when he was 3 yrs. old. My sister is also living with type 1 and was diagnosed almost 9 yrs. ago at the age of 24.
Now, I want to say that my heart goes out to your daughter, you and your entire family. This is and will be a difficult time for all of you...I am not going to sugar coat it, but, please know that we volunteers are either living with diabetes or caring for or close to someone who is and WE are hear for you in addition to your daughter's Endocrinologist who is the person that needs to be your PRIMARY source of obtaining information pertaining to your daughter's diabetes.
You should always talk to her doctor about any advice someone gives you....especially now because this is so new to you.
We have our glucometer set to read the blood sugar in mg/dl and this is what I found out when converting. (I welcome any volunteer to post if this info. is inaccurate - as far as the conversion goes.)
25.4 = 512 mg/dl
and
27.8 = 560 mg/dl
My son's glucometer would say HI danger call Dr. if he was over 600 mg/dl.
I am VERY sorry to hear that the children's ward was unhelpful! (not right at all!)
Have you been assigned a Endocrinologist or referred to one??? This is the beginning and you NEED the proper tools to take care of your daughter and to help her learn, as well.
Do you have a pediatrician for her that you are comfortable with who can refer you to a Pediatric Endocrinologist? (if you have not yet been refered)
My first impulse (response) would be to say that the Doc needs to raise the insulin dose, but sometimes they start off conservatively, HOWEVER, we do not want to see blood sugars that high.
(NOTE: always make sure her fingers/hands are clean because if she has sugar on her fingers there could be a false high or the reading could be higher than what it really is.) We carry alcohol swabs with us for when he cannot wash his hands...he can simply wipe a finger off and test.
There are so many questions that I have for you and so much that you will learn as time goes on.
What type of insulin is she on?
How often? A sliding scale or insulin to cover the food she eats?
If she is not taking insulin every time she eats (to cover the food), did anyone tell you how many carbohydrates she should have per meal? per snack?
What did this children's ward tell you to do? Did you ever even get to talk to a doctor?
(A tip: this is so new to you and your daughter, so she may not yet know when she is LOW. If this is the case, this is what I did with my son - when he had a low reading, I would say, "Honey, whatever you are feeling right now....this feeling is low blood sugar." I did this for a while until he was able to say, "I'm low" or "I think I'm low.")
How many days did she stay in the hospital?
Did she have a lot of highs in the hospital?
For us it was a 3 day stay and it was a time of learning so much that my brain felt like it was going to EXPLODE! (We had to take a written test pertaining to what we had learned, before we left the hospital.) It was also a time for the doctors to find an appropiate dosage for our son. A lot of testing his blood sugar.
I do not know what to say. I cannot tell you to increase her insulin. I do know that the timeof day thatshe experienced the HIGHS would be taken into consideration when figuring which shot would need the dosage increased. (Which shot meaing what time of day the Dr. would tell you to go up on a particular insulin.)
I am so sorry that it sounds like you / your daughter are not getting the care you need right now.
Emotionally, this disease is draining and at the beginning especially.
Please re-post with some more info.
I REALLY want to help.
Your posting made me teary-eyed. I feel for you. Our children are precious and you will ahev questions, as well as anxiety.
Continue to post and feel free to ask anything. Not to sound like a "know it all," but I have a lot of info. pertaining to ideas and care at school.
Warmest regards. I am sending you and your girl a cyber hug!!!!
S.S.
First, I want you to know that I am not a medical professional, so my input/advice is based on personal experience and knowledge from taking care of my son who is living with type 1 diabetes. He was diagnosed almost 7 yrs. ago when he was 3 yrs. old. My sister is also living with type 1 and was diagnosed almost 9 yrs. ago at the age of 24.
Now, I want to say that my heart goes out to your daughter, you and your entire family. This is and will be a difficult time for all of you...I am not going to sugar coat it, but, please know that we volunteers are either living with diabetes or caring for or close to someone who is and WE are hear for you in addition to your daughter's Endocrinologist who is the person that needs to be your PRIMARY source of obtaining information pertaining to your daughter's diabetes.
You should always talk to her doctor about any advice someone gives you....especially now because this is so new to you.
We have our glucometer set to read the blood sugar in mg/dl and this is what I found out when converting. (I welcome any volunteer to post if this info. is inaccurate - as far as the conversion goes.)
25.4 = 512 mg/dl
and
27.8 = 560 mg/dl
My son's glucometer would say HI danger call Dr. if he was over 600 mg/dl.
I am VERY sorry to hear that the children's ward was unhelpful! (not right at all!)
Have you been assigned a Endocrinologist or referred to one??? This is the beginning and you NEED the proper tools to take care of your daughter and to help her learn, as well.
Do you have a pediatrician for her that you are comfortable with who can refer you to a Pediatric Endocrinologist? (if you have not yet been refered)
My first impulse (response) would be to say that the Doc needs to raise the insulin dose, but sometimes they start off conservatively, HOWEVER, we do not want to see blood sugars that high.
(NOTE: always make sure her fingers/hands are clean because if she has sugar on her fingers there could be a false high or the reading could be higher than what it really is.) We carry alcohol swabs with us for when he cannot wash his hands...he can simply wipe a finger off and test.
There are so many questions that I have for you and so much that you will learn as time goes on.
What type of insulin is she on?
How often? A sliding scale or insulin to cover the food she eats?
If she is not taking insulin every time she eats (to cover the food), did anyone tell you how many carbohydrates she should have per meal? per snack?
What did this children's ward tell you to do? Did you ever even get to talk to a doctor?
(A tip: this is so new to you and your daughter, so she may not yet know when she is LOW. If this is the case, this is what I did with my son - when he had a low reading, I would say, "Honey, whatever you are feeling right now....this feeling is low blood sugar." I did this for a while until he was able to say, "I'm low" or "I think I'm low.")
How many days did she stay in the hospital?
Did she have a lot of highs in the hospital?
For us it was a 3 day stay and it was a time of learning so much that my brain felt like it was going to EXPLODE! (We had to take a written test pertaining to what we had learned, before we left the hospital.) It was also a time for the doctors to find an appropiate dosage for our son. A lot of testing his blood sugar.
I do not know what to say. I cannot tell you to increase her insulin. I do know that the timeof day thatshe experienced the HIGHS would be taken into consideration when figuring which shot would need the dosage increased. (Which shot meaing what time of day the Dr. would tell you to go up on a particular insulin.)
I am so sorry that it sounds like you / your daughter are not getting the care you need right now.
Emotionally, this disease is draining and at the beginning especially.
Please re-post with some more info.
I REALLY want to help.
Your posting made me teary-eyed. I feel for you. Our children are precious and you will ahev questions, as well as anxiety.
Continue to post and feel free to ask anything. Not to sound like a "know it all," but I have a lot of info. pertaining to ideas and care at school.
Warmest regards. I am sending you and your girl a cyber hug!!!!
S.S.
Those readings are very high. Presumably your daughter was in hospital to be stabilised on insulin. And her blood sugar levels should be below 10. Could she have missed an insulin shot? I would take her stratight back to the hospital. They will probably have to use insulin to get her blood sugar levels into the target range. You really don't want her to go into ketoacidosis.
Cheers,
Mark
Cheers,
Mark
Dear Sewing_pirate,
I need you to know that none of us here are physicians, but coming from our own life experience with type 1 diabetes. My son was diagnosed 20 years ago.
Please understand that I am from the U.S.and am not as familar with the metric system as I should be. From past questions and answers in this forum, I would take Markie's comment to heart. He/She (sorry, Markie) has always given wonderful information and I personally feel knows the metric system.
From what I know, you do need to get your daughter back into an E.R. right away. She needs to be stabilized. Even with my own limited knowledge of the metric system, I did check and she is in my opinion, running very high blood sugars. If you are still getting such unresponsive care, call other hospitals if you can. If you don't have that option, feel strong to push it to the limits. I have had to do this many times in my own son's life.
I want to recommend that you contact our JDRF website to connect with our online diabetes support team for a one on one volunteer that you can speak to. The site is www.jdrf.org/supportteam. This team is so helpful. I am also going to suggest www.childrenwithdiabetes.com for additional wonderful information.
The important thing right now is to get your daughter help. I know how numb and helpless you may be feeling. We have all gone through this as a parent or family member. The information that we have to learn in such a short time is overwhelming, but getting those blood sugars down is so important.
Please keep in touch and let us know how you are both doing.
Best,
dm
I need you to know that none of us here are physicians, but coming from our own life experience with type 1 diabetes. My son was diagnosed 20 years ago.
Please understand that I am from the U.S.and am not as familar with the metric system as I should be. From past questions and answers in this forum, I would take Markie's comment to heart. He/She (sorry, Markie) has always given wonderful information and I personally feel knows the metric system.
From what I know, you do need to get your daughter back into an E.R. right away. She needs to be stabilized. Even with my own limited knowledge of the metric system, I did check and she is in my opinion, running very high blood sugars. If you are still getting such unresponsive care, call other hospitals if you can. If you don't have that option, feel strong to push it to the limits. I have had to do this many times in my own son's life.
I want to recommend that you contact our JDRF website to connect with our online diabetes support team for a one on one volunteer that you can speak to. The site is www.jdrf.org/supportteam. This team is so helpful. I am also going to suggest www.childrenwithdiabetes.com for additional wonderful information.
The important thing right now is to get your daughter help. I know how numb and helpless you may be feeling. We have all gone through this as a parent or family member. The information that we have to learn in such a short time is overwhelming, but getting those blood sugars down is so important.
Please keep in touch and let us know how you are both doing.
Best,
dm
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