So, lately we've been chipping away at honing in Liam's sugars and we're down to 6.8% AIC right now. However, I'm puzzled about something. So, check this out and let me know if you have any ideas of what could be going on and/or any ideas for how to fix it.
So 75% of the time we are in the "good range" (80 - 180 is our range right now.)
But there is ONE time of the day that I just can NOT get "tamed". Every morning when he eats breakfast at 10:30, inevitably, he skyrockets up to over 250. Sometimes over 300, and TODAY OVER 400!
He usually eats between 25 - 35 carbs for breakfast.
First, a disclaimer: He IS sick right now...he has congestion/coughing...just a regular cold (we took him to Dr's to verify it wasn't the flu or pneumonia.)
So, to try and compensate for this known spike, and for the fact that he's sick, I've done several things. First, I created a separate "Sick" basal rate profile and upp'd all of his basal rates because he's required a lot more insulin (double) over the past week than usual. Below is his "normal" Daytime insulin regimen, then under that is his "Sick" insulin regimen.
"Sick" basal profile
Here are the trends (highs) over the past 4 days:
Based on previous days, I've continued doing a couple things.
First, I've INCREASED his basal rate, DAILY, within the "Sick" profile to what it is currently at .50u/hr. (I've gradaully gone up by 5's from the usual Daytime .25/hr.)
Second, I've DECREASED his I:C ratio for this time frame from his usual 28 carbs per unit, to 26 carbs per unit.
So, my question is....am I doing something wrong here??? Should I just JUMP UP to 1 unit/hr for this time frame and put his I:C at like 20 or something?
It just seems like the HIGHER I go with his BASAL rates during this time period, and the LOWER I push his I:C, the HIGHER his BG is! And that just makes no sense to me! Right now, his BG is FINALLY dropping, so I know the Insulin is in his body and is working. It's just not working like I had anticipated it should...and not like it does the rest of the day (as you can see by the trending information.)
Please note, here is how his meal goes down for this specific time period.
IF his BG is above an acceptable level, I don't feed him; instead I just correct and wait for his BG's to be in an acceptable level first, then I bolus and feed him.
For all the trending information listed above, his BG's have all been in the right range before eating, so we've been able to bolus and feed him according to the usual protocol, which is as follows:
At 10:15AM, check sugars and bolus him.
At 10:30AM, he eats.
This is the same thing we do every day for his breakfast...we finally got into a pattern of feeding him at the exact times each day as we found (and we knew this beforehand which is what led to the change) that doing this makes his body react in similar ways every day; instead of the body never knowing when it can expect to receive energy.
So he eats every day at 10:30AM, 2:30PM and 6:30PM, then he gets a snack before bedtime. We don't do snacks in between right now because that was throwing off our basal testing.
So, any help would be greatly appreciated. I'd love to get this figured out. I have most of the rest of the day pretty well under control right now...there are occasional smaller spikes, but this one time of the day is just kicking my a$$.
I watched his sugars rise this morning to over 400 and stay there now for over an hour. It's finally dropping, but the last time I checked his BG at 12:47PM, it was 404.