Rileys has been dropping low over night and has not been very high during the day either. Last night at 8 she went to bed at 241 by 2 a.m. she was down to 114. At 4 a.m. she was at 60. I changed her from 1:10 to 1:20 and I know its not her insulin its her activity. We have family her from cali right now and she is all over the place. So do I need her to eat more and different kinds of carbs to last her longer over night or what? During the day she has been between 73 and 114 so those are good but still on the lower side heck at one point I only gave her one unit for almost 40 carbs because I knew and sure enough that was when she was 73 but it was time to eat again. She doesnt feel these lows cause she is to busy playing so how do I balance this out?
Is she eating protein before bed? I always had to have a spoonful of peanut butter to hold me steady overnight. (I still do this if I've had a lot of activity or if my blood sugars run low during the evening hours. )
Jessica, It sounds like she might need less basal insulin. I'm not an endo so I can't say what that adjustment would be... but if she tends to run low most of the time, and especially if she hasn't eaten for a few hours... it's the basal rate.
Jessica, It sounds like she might need less basal insulin. I'm not an endo so I can't say what that adjustment would be... but if she tends to run low most of the time, and especially if she hasn't eaten for a few hours... it's the basal rate.[/quote]
This is what I was thinking. Does she take her long acting in the AM and PM? If so, maybe just less at night would be a good place to start. If there is extra activity during the day maybe a little less carb coverage would help. (Of course, I'm not a doctor either.)
She needs less basal. Before-meal insulin usually will not lower blood sugar beyond the 4-hours after the meal. If she's dropping all night, then it's the basal. The fact that she's been lower during the day too tells me it's the basal. If it were me, I'd lower it by 10% and see how things go.
Ok thanks I thought about that last night after I gave it to her. I had to change her before meal amounts because she would drop low from that too if I kept it at 1:15 she has been ok during the day at 1:20. She does get her levemir at night so I will back it off a unit or two tonight and see how she does. Oh and she does have a protein at bed time every night.
Hey Jessica, all ya need to do is drop that basal down some. Best way to judge the basal rate is with the fasting numbers from when she wakes up in the morning. The basals main job is to cover the sugars that your body releases naturally. Our endo's pattern management class told us to decrease by 20% if having to lower insulin amounts. So if she is on 5 units of lantus or levimar then it would drop down to 4 units. Her carb ratio might be fine the way it was, just that the basal was to high for her.
I agree that it sounds like an issue with her basal rate. Since she's so newly diagnosed, I don't think I'd try to change the dose on my own. Can you put in a call her endo or CDE for some input?
Sounds like you are learning a lot with the new regimin. It does sound like the basal is a little high. You may want to lower it and do an every two hour BG during the night to see what is happening. Make sure there is no bolus overlapping during the night.
It may take a few day for changes with the long acting to take full affect on the basal. Be patient. Adding more food to take care of the overnight low may mask the real issue.
Sounds like the ups and downs are a challenge. I would take my time and change only one thing at a time to make sure I'm not masking anything with additional things in the mix.
Keep us informed on what you come up with.
I dropped her 2 units last night and she stayed on the higher end all night. Its hard because her activity level is not normally this high. At school she sits 95% of her day. At home she doesnt have anyone who wants to play outside with her much and she wont go out there for long by herself. This week she has been on the trampoline most of the day. Its good to know this now tho because this summer she is going to be a lot more active.
The dne we have said we can adjust either insulin when we felt the need. I already dropped her levemir from 25 units to 23 a while back. I just brain farted it this time for some reason that that was the problem with the higher activity level.