Son's numbers staying too high?

Hey everyone,

Just to start off, I have emailed/called my son's doctor about this but wondering if there's any other parents out there who have had the same issue.

My son is 22 months old, diagnosed at 20 months so this is still kinda new to us. They had put his ratio for every 65 carbs, he'd get 1 unit. At first this worked, now his BG numbers are staying in the 250-300's consistantly. My husband and I find ourselves giving him 2 units at almost every meal. At his last appointment, his doctor mentioned changing his breakfast ratio down to 60 and keeping his carb intake between 40-60; making it just below 1 unit per meal. That'd be great if his BG number wasn't giving him an extra unit! Even his "middle-of-the-night" check is in the high 300's to low 400's.

I left his doctor a message as well as emailed him my son's BG numbers for the past 2 weeks, but has anyone had this issue made just made the choice to lower his ratio? I have gone ahead and changed it to the 60 carbs for each unit but we're still not seeing much of a difference. The only other "option"  we have at the moment, without hearing from his doctor, is to change his Lantus at night. He gets 3 units right now and we could up it to 4 but, and like I mentioned, we're still somewhat new, it scares me that this would put him low at night.

Alright, thanks for any advice or just thoughts!!!


Call your doctor today and ask him for immediate advice.  I don't want to make recommendations for your son because a small insulin change has a big effect for someone so little.

Make sure your son is getting lots of water and other beverages.  Higher blood sugars cause bad dehydration because his kidneys take all the available water to flush out the extra glucose they've cleaned out of the blood.  

Has your doctor recommended a correction factor?  That's the amount blood sugar is lowered from 1 unit of insulin.  You need to know this to lower the high right away, then can evaluate where other changes are needed.

It's normal for insulin needs to increase, both from the pancreas making less insulin and from your son growing.  If his blood sugars are higher all the time, then you may need to increase the Lantus.  Once blood sugars are mostly in a good range then the next step is to adjust carb ratios.  A 1:60 ratio is pretty average for someone his age and size.  Also, if you're using a carb ratio there's no need to limit the number of carbohydrates eaten.  The point of carb ratios is that they allow you to eat a flexible diet, and adjust insulin to match carbs consumed.  

If your son is fighting off an illness or infection it can make blood sugars go up.  Ask you doctor how to handle sick days.  (Usually requires taking larger meal doses to correct the highs.)

Make sure to talk to your son's doctor right away and he should recommend changes for you to make immediately.  It is okay to make insulin adjustments yourself, but seek your doctor's guidance now since you're still very new to this.  Take care and let us know what the doctor says.

A couple good books that your library may have and Amazon definite has:

Using Insulin by John Walsh

Think Like a Pancreas by Gary Scheiner

I would definitely be persistent in getting input from your endo.  If you're not yet comfortable making adjustments to ratios and correction factors yourself, then wait for the endo office to guide you, but don't let them delay more than a day or two in getting back to you.  It will take a little while, but eventually you will get the hang of spotting trends and knowing how to make adjustments, but you need to have enough experience under your belt to be comfortable doing it yourself.  It took a good year and a half, and a lot of reading up on diabetes, to get comfortable enough to start making adjustments myself, and our son's A1c has generally stayed in the 7.0-7.5 range (except this last visit was 8.0...stupid growth hormones!).  And, I agree that "Think Like A Pancreas" is an invaluable tool in managing diabetes.

Hang in there!



It seems as though your doctor is not as responsive as he should be.  Certainly in the first few months post diagnosis, your doctor should expect to support you in your day-to-day decisions for your son.  You need to be more aggressive in asking for help or seek another doctor.

Hey guys,

My son has like 4 doctors at the moment for endo. 2 of which I can call day or night and get ahold of without an issue. My husband and I did take care of the situation. I was just really asking if anyone else had delt with this issue with their toddler and how often to expect to deal with it.  I do appreciate everyones advice and comments though! Please don't take that the wrong way.

Glad everything has worked out.  Your son will experience insulin changes and unexpected blood sugars probably for most of his life.  I've had D for 34 years and still make frequent insulin adjustments, have surprise highs, and occasional lows.  

It's nothing to stress over.  You just do your best and correct as needed.  Take care.

I think you can expect to see (sometimes significant) fluctuations in insulin requirements throughout childhood.  Our son is 10.  On Sat night he had persistent highs (200-280) which did not come down with corrections (additional insulin) given three times.   On Sun night he was "in range" all night (I checked three times that night!).  I really don't know what to expect tonight, so I'll be checking him every few hours.  T1 management is as much an art as a science, at least while the kids are growing.  I'm hoping that things get a bit easier once he reaches adulthood, but am girding my loins for puberty ;)

Keep asking questions.  We all have been where you are now, and know where your heart is :)