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Number over 200

Question:

we test at all meals and bedtime routinely and if high at a meal time we add a unit of humalog or so , if high in betwwen meals at snack we do not give extra insulin at this time as sometimes you will get high readings after lunch or after school or something. We have only been doing this for not quite two years but my sons a1c has ranged between 5.6 and 6.5 every three months doing it that way. If the numbers are high at the mealtimes and shot times then the dose may n eed to be adjusted or snacks increased or decresed talk it over with your pediatric endocrinologist ctantiques

Response:

Check out the childrenwithdiabeteswebsite they will probably info on studies they also have a diabetic team area and you might want to check the index of past questions relating to hypogycemia http://www.childrenwithdiabetes ctantiques

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 I believe it was someone on this thread who mentioned something about hypoglycemia and its effects on the developing brain. This is a topic I am very interested in, both from a personal standpoint (having been diabetic since the age of ten and having lots of hypos) and a professional standpoint (one of my majors is elementary education so I am very interested in children, and I intend to study cognitive psychology in grad school). I’ve never really heard much information about it-just anecdotal speculation. I’d be really interested in hearing more about this from someone who’s been told more information about it or can reccomend some sources. Thanks so much to anyone who can help! Carolee — "In 1879, Wundt said: ‘Let there be psychology.’ And behold, there was darkness."     –Henry Gleitman

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Hi, everyone, it’s me again… My husband seems to think that we need to give Kendra a shot every  time she goes above 200.  He says that damage is done at that point.  That seems excessive to me!  He wants me to talk to the doc about that.  What figures do you all generally take action on? Thanx again. Lorna

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Your daughter is as young as my grandson and being so small it takes very little to bounce their levels around Humalin is in their system for twelve hours so when I give him a morning shot of 1.5 to 2 units of humilin he might have an elevated level at lunch but I have to remember the morning shot is still working. Without any additional shot he’s down to 70 or below by dinner.     My grandson has had readings of over 500 and just half a unit of Humilog has sent him dowm into the 20’s within 2 hours! The message here is each individual is different your going to have to try different combinations to see what works best for her.If you haven’t guessed I stay away for the Humilog unless He’s way up there and I going to be awake to keep an eye on him. MING TM

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We have had the same reactions.  Kendra can be really high and within 2 hours she is low.  That is pretty scary.   You are right.  Since she is so tiny (only 27 pounds) 1/2 H can be a lot. Another factor now is that she has hit her honeymoon.  More questions about that later.  I gave her the 1 of H and the 4 of N the other day and she hit a low of 35.  She had a hard time walking.  I gave her some juice right away and she perked right up. Thanx for your reply, LOrna

Response:

Hi, everyone, it’s me again… My husband seems to think that we need to give Kendra a shot every  time she goes above 200.  He says that damage is done at that point.  That seems excessive to me!  He wants me to talk to the doc about that.  What figures do you all generally take action on? Thanx again. Lorna

My daughters doctor has placed her "target range" at 150-250 due to her age and developing brain – he says at her age (four) it’s more dangerous to run the risk of super lows…  I wouldn’t give your daughter extra shots unless you speak with your physician first.

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I am certainly in no position to speculate on extra shots.  My doc is terrific.  I have her office number, her pager, and her home phone (though I have never used that one).  I page her (usually at dinner time) and she usually calls right away.  So, if I can not figure out what to do then I call her. Thanx, Lorna

Response:

we test at all meals and bedtime routinely and if high at a meal time we add a unit of humalog or so , if high in betwwen meals at snack we do not give extra insulin at this time as sometimes you will get high readings after lunch or after school or something. We have only been doing this for not quite two years but my sons a1c has ranged between 5.6 and 6.5 every three months doing it that way. If the numbers are high at the mealtimes and shot times then the dose may n eed to be adjusted or snacks increased or decresed talk it over with your pediatric endocrinologist ctantiques I think one important thing to consider is whether or not you’re mixing a longer acting insulin with the humalog or not. I personally do mix humalog with NPH, but I know that some people are on a routine that involves only humalog and shots after *every* meal or snack. If you’re doing only humalog, then it *might* be a good idea to increase the humalog dose. I know I don’t increase humalog for a high reading, because I know I’ve got some NPH hanging around in my body that may bring it down later and I don’t want to have a hypo!! I do, however, think *really really* carefully about what caused the high reading and try to correct it in the future. Example- once I had a spell of slightly high readings that I couldn’t figure out, then finally figured out it was due to using coffeemate instead of half and half. I agree with ctaniques that you need to discuss it with your doctor, though. I would also add that it’s important not to panic. Yes, prolonged readings of 200 and above will cause complications, and that’s bad. But the *ocassional* reading of 200 is nothing to panic about. If it is continously over 200 and you can’t figure out what’s causing that, that’s another thing to discuss with your doctor. I know that for me, feeling stressed out causes my glucose level to skyrocket independently of what I eat, and the last thing I ever needed was for someone to be panicking about a slightly high reading and making me panic too.  A *really* high reading, though, means you need to check for ketones and possibly increase insulin. But, again, the best thing to do is check with your doctor and find out what s/he reccomends for different levels of blood sugar, when to check for ketones, etc.  Good luck! Carolee — "In 1879, Wundt said: ‘Let there be psychology.’ And behold, there was darkness."     –Henry Gleitman

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