My daughter, age 11, was diagnosed last November. Her carb ratios have been pretty stable, but in May it seemed like she was starting to require more insulin because she was struggling with highs. We were considering adjusting ratios but were going on vacation so didn’t make any changes… Then, a couple days into vacation she started struggling with lows that we were consistently having to treat so we lowered her Lantus does from 6 to 4 units and were very conservative with insulin dosing to keep her from going low. This trending low was consistent for the 9 days on vacation, Today is our first full day back, and things seem to have swung back to staying high and increasing at bedtime . Any thoughts for what could be going on?
Hi @caryb welcome to the forum. I think you should take your notes and go over them with her doctor. In my opinion, insulin needs change with activity, stress, growth, and illness. What you are describing sounds typical to me- the excitement and additional movement on vacation usually reduces my insulin needs.
Growth, especially gaining weight, and normal growth hormones will usually require changes in Lantus and in meal time insulin. I think what you are doing is exactly what you’re supposed to be doing when you see an increase or decrease in blood sugar.
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Increase activity that is typical on vacation may have “offset” the highs she was starting to get. Insulin needs change for various reasons: with growth, time of the month; and I typically need to adjust a couple of times a year when the weather gets hotter and colder.
Your observations are excellent. Contact your doctor for guidance - if they have access to her CGM readings they may be able to advise you via a tele-health visit without having to go to the office for a review.
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@caryb Welcome Cary to The Breakthrough Community Forum!
To me, it sounds as if you are doing what you should be doing and as @Joe recommended take notes and share what is happening with her medical providers. Yes, our sensitivity to insulin can and will change from time-to-time and may be influenced by activity level and by ambient temperature and countless other factors.
During my seven decades living with diabetes I’ve found “the only constant is Change”. In the past, 1 unit of insulin would lower my BGL 40 mg/dl, now that single unit of insulin will lower my BGL 90 mg/gl.
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@caryb, I’d look at the pre/post vacation issues and vacation issues as separate items. Agree with comments here that activity can/does increase with vacations which naturally lowers BG. Also good comments on constant body changes to insulin sensitivity.
Something we have all had to learn with this disease is the numerous changes that turn us into investigators. It could be body changes, hormones, stress, etc… or issues with meds like insulin that is/went bad, clogged needles (cannulas for those on a pump), injection site absorption efficiencies, or other. The key is to stay alert to these items so you learn about them for next time. Unfortunately there is no one answer to your challenges, but know that we all get them and the more challenges you run into the better you get at troubleshooting!