We are 2 months into our diabetes management and I still feel like I don’t know what I am doing. Her target range is 80-180 and we are dosing her after meals for now. An hour or two after she eats she is in the 200-250 range. Is it normal to spike above the target range after her meals or is the target range where she needs to be ALL the time?
Also she still complains of headaches a lot. Does anyone else experience this?
Hi I am a mom of a T1d girl and I’m an RN. You don’t have to be in her target range all the time. It’s normal for T1ds to spike after eating. The insulin you give her with the meal is on board for two to three hours after she eats. You shouldn’t correct until after that time passes if need be. That being said, things like pizza or higher fat meals will keep her high longer. My daughter delays taking insulin for 1/2 hour when she eats pizza because the fat slows the carb absorption so blood sugar spike takes longer. I hope this helps. If you have questions I’m here! The best med for headaches is water. Teach her to like it if she doesn’t.
(I’m also and RN and T1D -44 years, as is my 10 year old daughter for the past three years.)
Is she on a pump or shots now? Spikes can occur after meals, particularly if she’s not taking insulin (whether shots or boluses) until after eating. (But that’s ok because you don’t know exactly what’s she’s going to eat so especially at the beginning, it’s OK to wait to see what carbs will be consumed, then take insulin to reduce the risk of taking too much insulin.)
The insulin takes a bit of time to start working so if the insulin is not there to “meet” the carbs, then her sugars will go up based on the carbs she’s consumed, then the insulin will start working a little later. If she’s on a pump, you might consider using a dual wave bolus for foods like pizza. This allows the bolus to be delivered over a period of time.
I’m 15 and was diagnosed 5 years ago now (wow didn’t realize it had been that long!)
first of all - breathe! I find that no matter what I do, my blood sugar will always go up after I eat, and my endo has said that that is completely normal.
Also, since she’s only 2 months into diagnosis, it’s possible her carb to insulin ration is slightly off. Mine has changed at least 6 times just in the past 2 years. If her insulin to carb ration is 1U for every 10g, try taking 1U/8g and so on.
If she’s having massive spikes and you can’t seem to control (like I do after breakfast, and only breakfast) you can try a couple of things.
One of the things is to try taking the insulin before she eats - if you aren’t already, you didn’t say. Sugar takes roughly 5 minutes to start raising your bloods whilst insulin takes 15-20 minutes. Therefore, try taking the insulin 15-20 min before she eats.
You can also try what’s called splitting the meal. Take insulin for the whole meal, but then have her eat only half of the meal, and eating the other half a few hours later, to balance out the spikes.
Have you tried using a CGM? It may seem soon as you are only two months in, but mine is a literal life saver. I find that it really helps show the spikes that you don’t find with finger sticks.
Just remember, you are only 2 months in! It can also just be her body adjusting. One of the biggest tips that I have learned is don’t be afraid to experiment a little bit. Change her ratios, etc.
Good luck! You go mama!
Thanks so much for the quick responses. She is not on a pump yet. We asked about it at our last appointment and the dr said we will have to wait at least a year. I feel much more confident after hearing from you.
Yeah it’s pretty standard that they make you wait a year, everyone i have talked to has to. However, the CGM that isn’t integrated into the pump (Dexcom (http://dexcom.com/) - way better than medtronics, I used the medtronics one and hated it with a passion!) is definitely worth looking into, if she’s up for it. I started using a Dexcom at age 14, I wish I had done it earlier, and it has also done my parents a world of good. I don’t wake up at night and so my parents have been doing all of my blood sugars during the night since day one. Using the Dexcom gives them the peace of mind knowing that if anything happens that we don’t expect, which when you hit teenage years is a lot because of all of the growth hormones, there is always a second eye.
Oh and i found that waiting that year before getting my pump was definitely good. It basically assures that if you’re pump ever fails (which it did to me) you are comfortable injecting and knowing what to do.
Good luck! And if you have any question feel free to write back