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mom24grlz

Overnight numbers

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mom24grlz

Here is our latest frustration. First off Ashleigh has dawn phenomenon. She always had, and it was pretty easy to handle on the insulin pump. Not so easy for us on Lantus injections. Ashleigh does split dose of Lantus, at 7am and 8pm. Last week Lantus was 16u at night. But she kept dropping overnight to the 60s and 70s. the only good thing was, her fasting numbers were decent (90-110). But i decided to decrease Lantus by 1 unit (because the darn pen only comes in whole units). Now she's running 135-140 overnight, but waking up between 175-185! I really can't win. And honestly I don't like the 130s and 140s overnight either. Id rather have her between 80-100. But I'm afraid if we go back to 16 units she'll start dropping into the 60s again. I have contemplated making her use a syringe for nighttime lantus that way we can do 15.5 units, even though I know how much she hates them.

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Rbubbaray

For me those numbers are good 130-140  , when i was running 200s at morning , but i just really started treating mine .. 60 yeah that something to watch thats my dads issue low numbers and i am high . today at morning time was the lowest i ever been at in a years .. 114 , and i had some light beers last night , and munched on dry cereal total . maybe this 500 metformin is kicking in . Mom24 maybe call doctor and explain the change of numbers for some advice . my dad is on the pen but I am not yet . goodluck .

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NoraWI

Can't Ashleigh go back on the pump? I could never get control over the DP until I started pumping and now it's a snap. Oh, and I did use a syringe for my Lantus but it was an iffy thing. I can't remember now why Ashleigh quit using the pump. I find it makes life so much easier!

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moe22

I don't have DP or Type 1 diabetes but I'd try giving her 15 Units at  night & then say around 2:00 to 3:00am. give her 1 whole unit her ( set the alarm clock) This is much like a 2:00 am. feeding for a baby ; after all there still you're baby no matter there age or if there in there teens or whatever there age....right???

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mom24grlz

Can't Ashleigh go back on the pump? I could never get control over the DP until I started pumping and now it's a snap. Oh, and I did use a syringe for my Lantus but it was an iffy thing. I can't remember now why Ashleigh quit using the pump. I find it makes life so much easier!

 

She doesn't want to. I'm surprised her "break" has lasted this long.  But so far she has been consistant about not wanting to return to the pump.  For the most part her numbers are good. Last A1C was 6.2% but we just struggle with the dawn phenomenon.  She went off the pump because her A1C was going up and she was getting a lot of 200+ numbers. 

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NoraWI

Well, if she doesn't want to... Pity though. I love my pump and things like DP are so easily taken care of with a tweak of the early morning basal. Would she be willing to wear the pump overnight? Otherwise, the only thing that occurs to me is playing with a tiny snack before bedtime and using the larger amount of Lantus. Not a great solution but... Maybe someone else can come up with a better suggestion. However, Ashleigh's A1cs have been decent... for a teen :). Is she graduating high school this year?

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JohnSchroeder

Sounds like her control is great!  6.2 A1C is amazing for any type 1, doubly so for a child.

 

What confuses me is the use of a basal insulin to counteract DP.  Does she not take any bolus?  I would just increase the dosage of her Novolog/humalog/R in the morning by a couple units.

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GrammaBear

Here is our latest frustration. First off Ashleigh has dawn phenomenon. She always had, and it was pretty easy to handle on the insulin pump. Not so easy for us on Lantus injections. Ashleigh does split dose of Lantus, at 7am and 8pm. Last week Lantus was 16u at night. But she kept dropping overnight to the 60s and 70s. the only good thing was, her fasting numbers were decent (90-110). But i decided to decrease Lantus by 1 unit (because the darn pen only comes in whole units). Now she's running 135-140 overnight, but waking up between 175-185! I really can't win. And honestly I don't like the 130s and 140s overnight either. Id rather have her between 80-100. But I'm afraid if we go back to 16 units she'll start dropping into the 60s again. I have contemplated making her use a syringe for nighttime lantus that way we can do 15.5 units, even though I know how much she hates them.

 

I don't know if this pen is available in the U.S., but if it is, maybe this would be of help to Ashleigh.

 

http://www.mystarsanofi.com/web/products/insulin-pens/juniorstar

 

It is understandable that you don't like her numbers to be 130-140 as that puts her at greater risk for complications.  Does she use the NovoPen Echo for her Novolog?  I know I used it when I was on MDI and it was easier to dose more accurately.

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Sobriquet

I changed to the Berlipen for that reason - it uses half units. It should work with any insulin, although of course they recommend it for their own products only. The pen is only available in white, but she could always paint it with nail polish or something if that is a problem.

The website is here - for Germany - http://www.berlin-chemie.de/Patienten/Diabetes/BerliPen-R/BerliPen-R-PRECISION

 

if you click the link for English at the top, then go to your country, you might be able to order it through them. Or try amazon.

If you get desperate, PM me and i can try and send one to you through the mail.

 

Which raises the question - are there generic pens available? Seems weird that we are bound to the products put out by the insulin producers...

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mom24grlz

Well, if she doesn't want to... Pity though. I love my pump and things like DP are so easily taken care of with a tweak of the early morning basal. Would she be willing to wear the pump overnight? Otherwise, the only thing that occurs to me is playing with a tiny snack before bedtime and using the larger amount of Lantus. Not a great solution but... Maybe someone else can come up with a better suggestion. However, Ashleigh's A1cs have been decent... for a teen :). Is she graduating high school this year?

Never thought about just wearing the pump at night. But i doubt she'd go for it. Last night her numbers were pretty good. I thought she accidentally took 16u lantus instead of 15, but Ashleigh said she took the correct amount. Midnight she was 122, 3am 89 and fasting/breakfast she was 102. Hoping the rest of the day has good numbers. Yesterday she was stuck in the 180s during school hours. she's there again today we may look into bumping up her breakfast ratio. She graduates next year.

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mom24grlz

Sounds like her control is great!  6.2 A1C is amazing for any type 1, doubly so for a child.

 

What confuses me is the use of a basal insulin to counteract DP.  Does she not take any bolus?  I would just increase the dosage of her Novolog/humalog/R in the morning by a couple units.

Ashleigh does the split dose of Lantus. We tried one dose but found her numbers were spiking up and down a lot. 300s in the AM, in range in the afternoon, 50-70 evening and overnight. But once we switched to 2 shots (am and pm) the numbers were more steady. She still takes bolus insulins for meals and if she needs a correction. I do give a correction bolus when she is high. But sometimes when she wakes up high we're chasing highs all day. Like yesterday she stayed in the 180s from 7am-3pm despite correction boluses.

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mom24grlz

Lantus is only avaible in whole unit pens here in the US. I wish it came in half unit pens or penfills. I just recently switched Ashleigh from the novolog flexpen (whole units) to novopen echo (half units). i keep thinking it would be nice if lantus had a penfill that way i could just put it in the extra pen i have.

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mom24grlz

I changed to the Berlipen for that reason - it uses half units. It should work with any insulin, although of course they recommend it for their own products only. The pen is only available in white, but she could always paint it with nail polish or something if that is a problem.

The website is here - for Germany - http://www.berlin-chemie.de/Patienten/Diabetes/BerliPen-R/BerliPen-R-PRECISION

 

if you click the link for English at the top, then go to your country, you might be able to order it through them. Or try amazon.

If you get desperate, PM me and i can try and send one to you through the mail.

 

Which raises the question - are there generic pens available? Seems weird that we are bound to the products put out by the insulin producers...

The berlipen junior looks similar to the novopen echo. I havent seen any generic pens yet. We do have 1/2 u syringes here and if we absolutely have to i could pull the Lantus out of the pen and give her half units that way. We used to do that with novolog when she still used whole units flexpens.

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Sobriquet

The pens we have here are reusable - I'm not sure if that is what you are using. If i can help with sourcing a 1/2 unit reusable pen, just let me know.

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mom24grlz

The pens we have here are reusable - I'm not sure if that is what you are using. If i can help with sourcing a 1/2 unit reusable pen, just let me know.

 

The novolog pen she has is reusable. The Lantus pens are throw-a-way.  Good news though, numbers have gotten a bit better. I still have her on the 15 u at night.  I went over her numbers over the past 7 days last night.  She's in range about 73% of the time at night and around 68% during the day. So i think we'll just stick with the 19u (AM) and 15u (PM) at this time.

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