My daughter (7 yr old) has been on a pump for over a year and we've never seen anything like this. Her BG is constantly very high and it seems as though we can't give her enough insulin. We have doubled her basal in the past couple months. I guess we need to adjust her I:C as well, but even corrections are not working as they should - even with rage bolusing. She usually needs a lot LESS insulin in the summer.

Because we've had such trouble with high BG lately, I gave a very generous correction with her lunch pre-bolus and her Dex was showing double down arrows by the time she started to eat. She ate the slow carbs first and was in no hurry about it, so I thought she might be heading for a bad low. Instead, she went high by the end of the meal. I gave a correction, but it seemed to have no affect. In fact, she spiked super high while running around playing outside a couple hours later. No apparent reason.

We've been changing sets and using new vials of insulin, thinking one of those was to blame. It has made no difference and this has been going on for weeks.

I'm wondering if she has some other health condition (chronic infection or something) causing this. However, she mostly feels fine and has no fever. I will be contacting her doctor tomorrow, but thought I'd ask you all for your input.

Have any of you ever seen anything like this before?

My daughter (7 yr old) has been on a pump for over a year and we've never seen anything like this. Her BG is constantly very high and it seems as though we can't give her enough insulin. We have doubled her basal in the past couple months. I guess we need to adjust her I:C as well, but even corrections are not working as they should - even with rage bolusing. She usually needs a lot LESS insulin in the summer.

Because we've had such trouble with high BG lately, I gave a very generous correction with her lunch pre-bolus and her Dex was showing double down arrows by the time she started to eat. She ate the slow carbs first and was in no hurry about it, so I thought she might be heading for a bad low. Instead, she went high by the end of the meal. I gave a correction, but it seemed to have no affect. In fact, she spiked super high while running around playing outside a couple hours later. No apparent reason.

We've been changing sets and using new vials of insulin, thinking one of those was to blame. It has made no difference and this has been going on for weeks.

I'm wondering if she has some other health condition (chronic infection or something) causing this. However, she mostly feels fine and has no fever. I will be contacting her doctor tomorrow, but thought I'd ask you all for your input.

Have any of you ever seen anything like this before?

My daughter (7 yr old) has been on a pump for over a year and we've never seen anything like this. Her BG is constantly very high and it seems as though we can't give her enough insulin. We have doubled her basal in the past couple months. I guess we need to adjust her I:C as well, but even corrections are not working as they should - even with rage bolusing. She usually needs a lot LESS insulin in the summer.

Because we've had such trouble with high BG lately, I gave a very generous correction with her lunch pre-bolus and her Dex was showing double down arrows by the time she started to eat. She ate the slow carbs first and was in no hurry about it, so I thought she might be heading for a bad low. Instead, she went high by the end of the meal. I gave a correction, but it seemed to have no affect. In fact, she spiked super high while running around playing outside a couple hours later. No apparent reason.

We've been changing sets and using new vials of insulin, thinking one of those was to blame. It has made no difference and this has been going on for weeks.

I'm wondering if she has some other health condition (chronic infection or something) causing this. However, she mostly feels fine and has no fever. I will be contacting her doctor tomorrow, but thought I'd ask you all for your input.

Have any of you ever seen anything like this before?

It could be the insulin itself. Have you tried another vial?

Have any of you ever seen anything like this before?

I agree with much of bkh's comments, especially regarding insulin resistance. It's been quite a while since I had to take an absurd amount of insulin to get past my BG into a normal range but I recall one episode where I took over maybe 3 times my daily dose.
I had to go back and re-read your note and I see you mention this going on for weeks in one place and doubling her basal in the past months.

There are too many possible variables that could be causing this and I think you need immediate medical assistance to get this attended to.
Good Luck!

Peter B

My daughter (7 yr old) has been on a pump for over a year and we've never seen anything like this. Her BG is constantly very high and it seems as though we can't give her enough insulin. We have doubled her basal in the past couple months. I guess we need to adjust her I:C as well, but even corrections are not working as they should - even with rage bolusing. She usually needs a lot LESS insulin in the summer.

Because we've had such trouble with high BG lately, I gave a very generous correction with her lunch pre-bolus and her Dex was showing double down arrows by the time she started to eat. She ate the slow carbs first and was in no hurry about it, so I thought she might be heading for a bad low. Instead, she went high by the end of the meal. I gave a correction, but it seemed to have no affect. In fact, she spiked super high while running around playing outside a couple hours later. No apparent reason.

We've been changing sets and using new vials of insulin, thinking one of those was to blame. It has made no difference and this has been going on for weeks.

I'm wondering if she has some other health condition (chronic infection or something) causing this. However, she mostly feels fine and has no fever. I will be contacting her doctor tomorrow, but thought I'd ask you all for your input.

Have any of you ever seen anything like this before?

Hi Clara's Mom,

I hope you got some answers and suggestions from the doctor. Certainly do whatever adjustments are needed. I don't know what kind of bg's you are dealing with but if you have struggled with adjustments for months, and the bg has been high for weeks, it is time to get to the doctor. I also wonder if she has some other health condition (chronic infection or something) causing this. I don't suspect that your kid is IR, but there could an issue with absorption. Also...and please don't get mad - but a 7 year old could be eating without your knowledge. Kids are famous for hiding crimes - even innocent ones. Let us know what you learn and best to you and Clara.

We've been so surprised / baffled by her increased basal need - especially in the summer. We just kept thinking she had a bad site, the insulin got hot, was getting sick, we screwed up a carb count, etc. I've also been slack on giving proper pre-bolus lately because I've been getting worn down on making her wait to eat. She's so fed up with it. So, we had to take a few days of being very strict with pre-bolus to eliminate that. Now that we have eliminated the set, site, insulin, and we are still seeing super high numbers, we've finally realized that something significant is going on. Her TDD has been at least double normal with all the corrections.

Hi, Clara's mom. I just have to say, I could make similar statements about my own experience treating myself, and I'm a highly-motivated adult with advanced technical degrees and plenty of instruction.

So in case you are starting to question yourself, my impression based on what I've read here is that you are doing a GREAT job. It's just a hard problem that tricks everyone from time to time. You're doing the right things, so just keep your courage and let us compliment you for taking such good care of Clara.

4 hours later, while running errands with me (so I know she didn't eat anything) she started going up again. I'm on the 3rd correction and she just keeps going up.

(IMG:style_emoticons/default/cool.gif) --><div class='quotetop'>QUOTE(Peter B @ Jul 26 2013, 05:52 AM) </div><div class='quotemain'><!--quotec-->I agree with much of bkh's comments, especially regarding insulin resistance. It's been quite a while since I had to take an absurd amount of insulin to get past my BG into a normal range but I recall one episode where I took over maybe 3 times my daily dose.
I had to go back and re-read your note and I see you mention this going on for weeks in one place and doubling her basal in the past months.

There are too many possible variables that could be causing this and I think you need immediate medical assistance to get this attended to.
Good Luck!

Peter B

I have a little formula in my head for increasing her correction based on her BG. I usually add 20% if she's 200-250, 30% 25-300, 40% over 300. However, she's never been high so much for so long before, so perhaps she has needed even more.

Regarding the timing of all this, I didn't say that very clearly, did I? We've been increasing her basal gradually over the past couple months and it has been working out, but over the last - I guess 2 weeks - she has been going high A LOT. Honestly, we don't pay too much attention if she has some weird BGs for a few days. We just correct and go on. So, I'm sure that I'm not giving correct times because I don't pay too much attention until it's really obvious that something is consistently off. As you say, there are so many factors and we've learned to just treat the BG and not overthink it. I need to go back and review the Dex data to really say it correctly.

We've been so surprised / baffled by her increased basal need - especially in the summer. We just kept thinking she had a bad site, the insulin got hot, was getting sick, we screwed up a carb count, etc. I've also been slack on giving proper pre-bolus lately because I've been getting worn down on making her wait to eat. She's so fed up with it. So, we had to take a few days of being very strict with pre-bolus to eliminate that. Now that we have eliminated the set, site, insulin, and we are still seeing super high numbers, we've finally realized that something significant is going on. Her TDD has been at least double normal with all the corrections.

Last night, several people on TuDiabetes suggested that she could be coming out of an extended honeymoon. Since it has been 2 yrs, 4 mo since Dx, I didn't think she could be, but I'm told that her insulin requirements have been very low even for a 7 yr old. (.05 U/hr basal)

Well, yay for the fasting. What did the doc say?

That's far enough after the meal that if it were me having the BG rise, I would start to think about increasing my basal (starting 2 hours before the BG rise starts.)

.05 U/hr is very low. It sounds like her basal rates have to be adjusted and varied. You mention Tu Diabetes. Have you ever visited the Children with Diabetes forum?

The unusual thing for her is that it took several corrections to get it to budge. She was around 230 and that doesn't usually happen unless she's over 300.

So, it may be that she is coming out of an extended honeymoon.

We were all set to send data to the doctor yesterday morning, but then it all changed suddenly again and she wasn't going high. It was like I had dreamed the hole thing. The rise in the afternoon looked like basal, but she wasn't all that high (230) and it still took several corrections to get her BG to move. I did increase her correction bolus because she was over 200, but still wouldn't budge.

I noticed that her last site (changed Thur eve) looked inflamed, so that could have been what made things so much worse on Thur night, but the ones before that looked fine and we still had problems. We are sticking to a very strict pre-bolus wait 20 minutes schedule all weekend to make sure we have the best results possible and then if things are still weird we'll send the data to the doc on Monday.
Absolutely and it looked like basal on the Dex. The unusual thing for her is that it took several corrections to get it to budge. She was around 230 and that doesn't usually happen unless she's over 300.
So, it may be that she is coming out of an extended honeymoon. How exciting, right when school is about to start (IMG:style_emoticons/default/rolleyes.gif)

Yes, I have been on Children with Diabetes forum.