Dawn Phenomenon??????????

[kel4han]

My six year old dx'd 12-4-06 seems to need double the Novolog with Breakfast. She will go to bed at 260 (I know) and wake at 150-180, so she drops alot at night. We have checked her every 2 hours at night this first few weeks after dx and she does not go "low" and rebound. But even if we give her the 1:40 for breakfast, she will still be 400 three hours later. Should we just try it and double that morning dose even though she is at school and has no idea yet how a hypo feels? Scared mom but I cant see her functioning well at school with these numbers. Any suggestions are helpful.

[duck]

Instead of doubling it, you could add a few units here and there until it's just right. You SHOULD contact the school and ask for a conference with the school nurse and advise them on what you are doing and why, and make sure they know what the corrective action should be if there is a problem. Testing A LOT is important right now as you figure this out.

Most people are insulin-resistant in the AM, and it manifests itself in many different ways. Your kid is exhibiting a need for additional insulin to cover what foods she does eat. Like I said, instead of doubling the dose, why not incrementally experiment. I am typically 1 unit to cover 8 grams of carbs, but in the AM I find 1 to 6 works better for me. If 1:40 is not sufficient, instead of going 1:20, how about 1:35 or 1:30?

[kel4han]

We have had conferences with the school nurse and she seems to always piss me off. I am a type I diabetic as well since March 06 and she seems to not believe anything I say, and always has her own old fashioned ideas on what I should be doing. She seems to always put in her two cents and it really enrages me that she thinks she knows how to handle this just because she is an RN. I am a diabetic and you can bet that makes me even more cautious in my child as I know things can be unpredicatable. I dont know what continuing education they are required to have but, hers is outdated. Makes sending your child to school very scary as they are in control of your childs every bodily need. Sorry, I had to vent that. Yes, I agree we should try and adjust by smaller amounts for the AM breakfast, it is just so hard to draw up .5 units. And our Pediatric pen does not dispense as it should, so we have to add a half a unit to each dose just becuase it continues to drip drip after removing the needle. Thanks for your help.

[duck]

We all have our horror stories about our healthcare providers...I'm sorry you have to deal with someone whose responsibility is to your child. Can you take your frustrations to the school's administrators WITHOUT the nurse present with the understanding you want to present your rationale for care? Maybe get your doctor to sign off on it as well?

I dunno, just thinking via keyboard...

What kind of pens/delivery devices do you use?

[xMenace]

My am dose is tripled.

It is my humble opinion that a pump is the best way to treat dawn phenoms. It would help her night BGs too.

The first rule in making adjustments is go slow!

[kel4han]

Well, we requested the Novolog pediatric pen for my daughter becuase at dx she was 1:80 for novolog. So, we wold typically use .5 units. We started her on 2units of levemir by the pen as well, and that proved to be too much. So, now at week three, I switched her to Novolog from the vial and syringe. Levemir pen at 1-1.5 units at dinner. Levemir pen has always been good, but that Novolog pediatric pen button is all messed up. Safer to stick with the syringe even though it is horrible to dose .5units in that thing.

[kel4han]

The first thing I did in the hospital was ask what the educators thought about the pump, and they dont choose that route. We have our first 2wk follow up on Wednsday and you can bet I will be asking again.

[duck]

The first thing I did in the hospital was ask what the educators thought about the pump, and they dont choose that route. We have our first 2wk follow up on Wednsday and you can bet I will be asking again.

Get a lot of info before you go...it may or may not be right for your daughter, but it will help you to be as educated about pumping as possible. They'll try to frighten you with stories about going too high/too low. Weird that this is a possibility WITHOUT a pump as well, but . . .

[DanG]

We all have our horror stories about our healthcare providers...I'm sorry you have to deal with someone whose responsibility is to your child. Can you take your frustrations to the school's administrators WITHOUT the nurse present with the understanding you want to present your rationale for care? Maybe get your doctor to sign off on it as well?

If at all possible, for you and your child, perhaps you take some time off to do schooling at home until you get this routine mastered? I mean, there are many people that school their kids at home all the time, and this is one major adjustment that might warrant that type of intervention.

I can recall back in the dark ages of technology when I was a kid in school that there was a student that listened to the classes via some type of phone thingie - very very low tech for sure. There are many kids that do not do school for a season - for whatever reason. This seems like a definite reason to "off" the school, especially with such dull witted "health professionals" in charge of the one student you really care about. Of course, that all depends on what your circumstances are.... just a suggestion...
DanG