high blood sugars in 300's

diabetcmom
By diabetcmom Latest Reply 2013-01-20 20:56:51 -0600
Started 2013-01-07 13:02:27 -0600

My daughter is 13, diagnosed a year ago, type 1. The last few months we keep increasing her lantus every couple weeks. In August she was at 24 and now 49 units. Is this normal? The doctors just say; she must need more insulin but I feel like something is wrong. Her numbers are normal for a couple weeks then start going up for the next two and we gradually raise the lantus every few days.


9 replies

Gwen214
Gwen214 2013-01-20 20:56:51 -0600 Report

Is she increasing after meals or is this fasting numbers? What is she eating or drinking? I was diagnosed when I was 12 and ate everything under the moon that was not good for me. That's when my doc told me to check my blood sugars 6 times a day. Before meals and 2 hours after meals, plus I had to write a food diary. Or maybe she's going through stress that can increase it also. She pretty much have to be open about what's going on medically with herself and let her doc or parents, so the doctor can see if there is a pattern with her eating or any other factors. Write everything down and give the information to the doc. The docs won't know unless there's communication.

John Crowley
John CrowleyCA 2013-01-08 12:19:43 -0600 Report

First of all, welcome to Diabetic Connect. You've found a great resource and have already received some good insights.

It is interesting that the increases you and your doctor have been implementing have been in her Lantus dose. Have you adjusted her fast-acting insulin dose or insulin-to-carb ratio at all as well?

The only way to know if you're adjusting the right thing is by careful before and after meal testing and checking and double checking your carb counting.

Lantus is a basal insulin. It's function is to provide that little bit of insulin constantly in the background. If your fast-acting insulin-to-carb ratio is right on and you're confident that you're counting carbs well and dosing your fast-acting insulin accurately, then you will see (as a general rule) the impact of too little Lantus first thing in the morning and right before meals.

So if your daughter is running high first thing in the morning and is high before meals (even though her before-bed and after-meal tests showed she was about where she should be), then increasing Lantus is most likely the right move. And as has been noted, a 13-year-old girl's body is going through significant changes and you're likely at the end of the honeymoon phase. These factors could easily combine to create significant changes in the Lantus dose.

The bottom line really is about testing and testing and testing to see what the patterns really are.

Here are a couple of links to some good posts that also might help you sort things out.

http://www.diabeticconnect.com/diabetes-articles/7-all-about-glucose-monitoring

http://www.diabeticconnect.com/videos/1405-counting-carbs-for-diabetics---episode-27---ask-amy

http://www.diabeticconnect.com/discussions/2805-dawn-phenonmenon

Set apart
Set apart 2013-01-08 05:40:04 -0600 Report

Have your doctors talked to you about the honeymoon phase which I was told can last up to a year. This means your pancreas still works for you from time to time. Are you monitoring her eating? I inject several times a day Lantus and novolog it works most of the time, but I would still ask about the pump! I like the way I do it because feel like I have control! Good luck!

IronOre
IronOre 2013-01-07 18:49:16 -0600 Report

I assume that she is also taking a short-acting insulin such as Novalog or Humalog . . . correct ? because (based on my experience) that is the one that usually gets the adjusting the most.
Is she seeing an endocrinologist for her diabetes ?

adamr1989
adamr1989 2013-01-07 18:04:15 -0600 Report

Ask about the pump. I have type 1 diabetes and have been on the pump since I was 9 years old. Also, ask about the Symlin Pen.

Type1Lou
Type1Lou 2013-01-07 18:00:04 -0600 Report

At 13, her body is undergoing significant changes just by growing up, unrelated to the diabetes. This makes it even harder to achieve good diabetes control, which, under the best of conditions is a constant balancing act. My PCP kept on increasing my Lantus dose in 2010 with disastrous results. I finally asked him for a referral to an endo and they changed the time of day I was taking Lantus and reduced my dose but, within a year, they recommended a pump. I started pumping in the Fall of 2011 and haven't regretted it. At 64, my body is also changing but I think I have it easier than your 13 year old. Do you have access to an endo who might specialize in treating teenagers? (Is there such a thing?…seems like there should be.)

jayabee52
jayabee52 2013-01-07 23:04:01 -0600 Report

Yes Lou there are Pediatric Endocrinologists around. Just Google Pediatric Endocrinology in [city/state] and see who may be available in the area

ShellyLargent
ShellyLargent 2013-01-07 15:30:15 -0600 Report

I was up to 100 units of Lantus twice a day with no effect. Lantus doesn't work for everyone. I agree with Manapua. Ask her doctor about an insulin pump. If he doesn't think she needs one, find another doctor. I've been on one for about 6 or 7 years now and love it. I was taking multiple injections: NpH in the morning, Regular for every meal and for corrections as needed, and then another injection of NpH at night. Some days I was injecting 6 to 8 times. And my numbers were still out of control. I was either too high (I got to the point where I simply refused to inject because I was tired of poking myself) or I was too low (over estimated what I was eating versus my insulin). An insulin pump could dramatically change her control.

manapua72
manapua72 2013-01-07 14:44:14 -0600 Report

They kept raising my Lantus too … More @ night , then they had me start taking in the mornings too … I'm now on the pump and only take fast acting Novolog … Also I use less insulin … Have u & your daughter considered a pump ???