So I'm getting further into Think Like a Pancreas, and I'm currently on Chapter 6 - Basal Insulin Dosing. I read the tables for the top/bottom ranges of both Basal and Total Daily insulin requirements for each age range and decided to "run the numbers" to see how our son fits into the recommended dosing.
What I found is our son's nowhere near where the "Young Child" range is (in fact, he's only about 1/2 the recommended dosing for his age). So I'm thinking maybe he's just too small to be considered a "Young Child" right now???...for purposes of the calculations in this book? See the two screenshots.
The first is the page showing the different ranges taken from Think Like a Pancreas, page 129...highlighted are the two that I feel most fit our son (Mostly inactive and Moderately active),
...and here is my Math...as you can see, using yesterdays numbers at the bottom of the page, he's only using about 1/2 the recommended dosing. What gives?
We had an epiphany...a realization yesterday that we corrected, and, since then, we've had no spikes over 250. We had been noticing that EVERY SINGLE meal, even though we were doing everything we were directed...giving the right dosing for the given carbs, waiting the required time, etc., our son was still spiking over 250...IN FACT, he was spiking over 300 and nearing 350. So, against Doctor's orders, I gave more insulin to bring down that number (because I can correct lows when he's awake easy, before they become lows.) Even though the Endo's don't seem to care what his sugars do for 2 hours after the meal, I DO. So, I had been giving .5 more Bolus correction after the fact because I refused to watch his sugars rise (and stay) above 250.
So, in discussing (sometimes with raised voice) this with my wife, we came to the realization that something is wrong. Upon further consideration, we decided it could really be only one thing...he's being prescribed too little insulin to cover the carbs he's eating. So, we decided that, instead of following the doctors orders and giving him 1/2 unit for every 20 carbs, we were going to give him 1/2 unit for only 15 carbs and see how that goes...and guess what? It's freaking worked! Since we made this change, there hasn't been one spike over 250 and his sugars have mostly been around or under 200, which I am so thrilled about.
See the below CGM meter screenshots.
Here are the numbers for the past 24 hours:
Here are the peaks above 200:
...and here is the time he's been under 200....this is a LARGE PERCENTAGE of the time...so this is definitely good for his A1C's.
So, the main purpose of this thread was to get TuD's input on why our numbers don't line up with the numbers recommended in Think Like a Pancreas, but the secondary goal is to just let those NEWLY DIAGNOSED people, or parents of toddlers especially, know that it's OK to make tweaks....
As I told my wife, the Doctor's don't give a crap if our son rides above 250 or 300 for hours at a time. And the Doctor's also won't have the loss associated with doing things wrong...as such, my wife and I finally are at the point where we won't sit idly by and let the doctors dictate things that we know, through our own research, understanding and trial and error just aren't right. That's why we adjusted his carb to insulin ratio and it's why we're also going to tell the Doctor that their ratios are just wrong...the numbers speak for themselves in our opinion.
Thanks for reading this long post. Looking forward to understanding why our numbers vary so widely (only 1/2) of what the book recommends, for both Basal and Total Daily Insulin.